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1. Amniocentesis and chorionic villus sampling in HIV-infected pregnant women: a multicentre case series

Author

Floridia M, Masuelli G, Meloni A, Cetin I, Tamburrini E, Cavaliere AF, Dalzero S, Sansone M, Alberico S, Guerra B, Spinillo A, Chiadò Fiorio Tin M, Ravizza M, Mori F, Ortolani P, Dalle Nogare ER, Di Lorenzo F, Sterrantino G, Meli M, Polemi S, Nocentini J, Baldini M, Montorzi G, Mazzetti M, Rogasi P, Borchi B, Vichi F, Del Pin B, Pinter E, Anzalone E, Marocco R, Mastroianni C, Mercurio VS, Carocci A, Grilli E, Maccabruni A, Zaramella M, Mariani B, Natalini Raponi G, Guaraldi G, Nardini G, Stentarelli C, Beghetto B, Degli Antoni AM, Molinari A, Crisalli MP, Donisi A, Piepoli M, Cerri V, Zuccotti G, Giacomet V, Coletto S, Di Nello F, Madia C, Placido G, Vivarelli A, Castelli P, Savalli F, Portelli V, Sabbatini F, Francisci D, Bernini L, Grossi P, Rizzi L, Maso G, Airoud M, Soppelsa G, Dedoni M, Cuboni C, Ortu F, Piano P, Citernesi A, Bordoni Vicini I, Luzi K, Roccio M, Vimercati A, Miccolis A, De Gennaro A, Cervi F, Simonazzi G, Margarito E, Capretti MG, Marsico C, Faldella G, Martinelli P, Agangi A, Capone A, Maruotti GM, Tibaldi C, Trentini L, Todros T, Frisina V, Brambilla T, Savasi V, Personeni C, Giaquinto C, Fiscon M, Rubino E, Bucceri A, Matrone R, Scaravelli G, Genovese O, Cafforio C, Pinnetti C, Liuzzi G, Tozzi V, Massetti P, Casadei AM, Cellini M, Castelli Gattinara G, Marconi AM, Sacchi V, Ierardi M, Polizzi C, Mattei A, Pirillo MF, Amici R, Galluzzo CM, Donnini S, Baroncelli S, Villani P, Cusato M, Cerioli A, De Martino M, Mastroiacovo P, Parazzini F, Vella S., Floridia M, Masuelli G, Meloni A, Cetin I, Tamburrini E, Cavaliere AF, Dalzero S, Sansone M, Alberico S, Guerra B, Spinillo A, Chiadò Fiorio Tin M, Ravizza M, and Mori F, Ortolani P, Dalle Nogare ER, Di Lorenzo F, Sterrantino G, Meli M, Polemi S, Nocentini J, Baldini M, Montorzi G, Mazzetti M, Rogasi P, Borchi B, Vichi F, Del Pin B, Pinter E, Anzalone E, Marocco R, Mastroianni C, Mercurio VS, Carocci A, Grilli E, Maccabruni A, Zaramella M, Mariani B, Natalini Raponi G, Guaraldi G, Nardini G, Stentarelli C, Beghetto B, Degli Antoni AM, Molinari A, Crisalli MP, Donisi A, Piepoli M, Cerri V, Zuccotti G, Giacomet V, Coletto S, Di Nello F, Madia C, Placido G, Vivarelli A, Castelli P, Savalli F, Portelli V, Sabbatini F, Francisci D, Bernini L, Grossi P, Rizzi L, Maso G, Airoud M, Soppelsa G, Dedoni M, Cuboni C, Ortu F, Piano P, Citernesi A, Bordoni Vicini I, Luzi K, Roccio M, Vimercati A, Miccolis A, De Gennaro A, Cervi F, Simonazzi G, Margarito E, Capretti MG, Marsico C, Faldella G, Martinelli P, Agangi A, Capone A, Maruotti GM, Tibaldi C, Trentini L, Todros T, Frisina V, Brambilla T, Savasi V, Personeni C, Giaquinto C, Fiscon M, Rubino E, Bucceri A, Matrone R, Scaravelli G, Genovese O, Cafforio C, Pinnetti C, Liuzzi G, Tozzi V, Massetti P, Casadei AM, Cellini M, Castelli Gattinara G, Marconi AM, Sacchi V, Ierardi M, Polizzi C, Mattei A, Pirillo MF, Amici R, Galluzzo CM, Donnini S, Baroncelli S, Villani P, Cusato M, Cerioli A, De Martino M, Mastroiacovo P, Parazzini F, Vella S.

Subjects
Infectious Disease Transmission, Prenatal diagnosis, HIV Infections, 0302 clinical medicine, Birth defect, Pregnancy, Odds Ratio, Vertical, Medicine, 030212 general & internal medicine, Pregnancy Complications, Infectious, education.field_of_study, Amniocentesi, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, Obstetrics, Infectious, Obstetrics and Gynecology, Amniocentesis, birth defects, chorionic villus sampling, HIV, invasive testing, mother-to child HIV transmission, pregnancy, prenatal diagnosis, Birth defects, Chorionic villus sampling, Invasive testing, Mother-to child HIV transmission, Anti-Retroviral Agents, Chorionic Villi Sampling, Female, Adult, medicine.medical_specialty, Prenatal diagnosi, Population, Settore MED/17 - MALATTIE INFETTIVE, 03 medical and health sciences, Humans, education, Fetal Death, Analysis of Variance, Chi-Square Distribution, business.industry, Infectious Disease Transmission, Vertical, Odds ratio, medicine.disease, Confidence interval, Pregnancy Complications, business, Chi-squared distribution
Abstract

Objectives To assess in pregnant women with HIV the rates of amniocentesis and chorionic villus sampling (CVS), and the outcomes associated with such procedures. Design Observational study. Data from the Italian National Program on Surveillance on Antiretroviral Treatment in Pregnancy were used. Setting University and hospital clinics. Population Pregnant women with HIV. Methods Temporal trends were analysed by analysis of variance and by the Chi-square test for trend. Quantitative variables were compared by Student's t-test and categorical data by the Chi-square test, with odds ratios and 95% confidence intervals calculated. Main outcome measures Rate of invasive testing, intrauterine death, HIV transmission. Results Between 2001 and 2015, among 2065 pregnancies in women with HIV, 113 (5.5%) had invasive tests performed. The procedures were conducted under antiretroviral treatment in 99 cases (87.6%), with a significant increase over time in the proportion of tests performed under highly active antiretroviral therapy (HAART) (100% in 2011–2015). Three intrauterine deaths were observed (2.6%), and 14 pregnancies were terminated because of fetal anomalies. Among 96 live newborns, eight had no information available on HIV status. Among the remaining 88 cases with either amniocentesis (n = 75), CVS (n = 12), or both (n = 1), two HIV transmissions occurred (2.3%). No HIV transmission occurred among the women who were on HAART at the time of invasive testing, and none after 2005. Conclusions The findings reinforce the assumption that invasive prenatal testing does not increase the risk of HIV vertical transmission among pregnant women under suppressive antiretroviral treatment. Tweetable abstract No HIV transmission occurred among women who underwent amniocentesis or CVS under effective anti-HIV regimens.

Published
2016
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3. Discontinuing combination antiretroviral therapy during the first trimester of pregnancy: insights from plasma human immunodeficiency virus-1 RNA viral load and CD4 cell count

Author

Bicceri, A. M., Somigliana, E., Matrone, R., Uberti-Foppa, C., Vigano, P., and Vignali, M.

Subjects
Highly active antiretroviral therapy -- Health aspects, Highly active antiretroviral therapy -- Complications, Pregnant women -- Health aspects, Pregnant women -- Diseases, Obstetrics -- Research, Health
Abstract

Research has been conducted on human immunodeficiency virus-1-infected pregnant women receiving antiretroviral medications. The authors report that the discontinuation of antiretroviral therapy during the first trimester of pregnancy will increase human immunodeficiency virus viral load and decline CD4 cell count.

Published
2003

5. Pregnancy outcomes and cytomegalovirus DNAaemia in HIV-infected pregnant women with CMV

Author

Ravizza, M., Tamburrini, E., Mori, F., Ortolani, P., dalle Nogare, E.R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V.S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A.M., Molinari, A., Crisalli, M.P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Bernini, L., Grossi, P., Rizzi, L., Alberico, S., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Spinillo, A., Roccio, M., Vimercati, A., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M.G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Capone, A., Maruotti, G.M., Tibaldi, C., Trentini, L., Todros, T., Masuelli, G., Frisina, V., Cetin, I., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Genovese, O., Cafforio, C., Pinnetti, C., Liuzzi, G., Tozzi, V., Massetti, P., Casadei, A.M., Cavaliere, A.F., Cellini, M., Castelli Gattinara, G., Marconi, A.M., Dalzero, S., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M.F., Amici, R., Galluzzo, C.M., Donnini, S., Baroncelli, S., Floridia, M., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Parazzini, F., Vella, S., and Degli Antoni, A.

Published
2016
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6. Rate, correlates and outcomes of repeat pregnancy in HIV-infected women

Author

Floridia, M., Tamburrini, E., Masuelli, G., Martinelli, P., Spinillo, A., Liuzzi, G., Vimercati, A., Alberico, S., Maccabruni, A., Pinnetti, C., Frisina, V., Dalzero, S., Ravizza, M., Mori, F., Ortolani, P., dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Bernini, L., Grossi, P., Rizzi, L., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Roccio, M., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Agangi, A., Capone, A., Maruotti, M., Tibaldi, C., Trentini, L., Todros, T., Cetin, I., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Casadei, A. M., Cavaliere, A. F., Cellini, M., Castelli Gattinara, G., Marconi, A. M., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Parazzini, F., Vella, S., Floridia, M, Tamburrini, E., Masuelli, G., Martinelli, P., Spinillo, A., Liuzzi, G., Vimercati, A., Alberico, S., Maccabruni, A., Pinnetti, C., Frisina, V., Dalzero, S., Ravizza, M. [, Faldella G., and ]

Subjects
0301 basic medicine, Adult, medicine.medical_specialty, HIV RNA, Anti-HIV Agents, birth weight, HIV, pregnancy, preterm delivery, Health Policy, Infectious Diseases, Pharmacology (medical), Birth weight, Emigrants and Immigrants, HIV Infections, Settore MED/17 - MALATTIE INFETTIVE, Pregnancy, Preterm delivery, CD4 Lymphocyte Count, Female, HIV-1, Humans, Premature Birth, Viral Load, Infant, Low Birth Weight, 03 medical and health sciences, medicine, Obstetrics, business.industry, Low Birth Weight, Infant, Odds ratio, medicine.disease, 030112 virology, Confidence interval, Pregnancy rate, Low birth weight, Premature birth, medicine.symptom, business, Viral load
Abstract

Objectives The aim of the study was to assess the rate, determinants, and outcomes of repeat pregnancies in women with HIV infection. Methods Data from a national study of pregnant women with HIV infection were used. Main outcomes were preterm delivery, low birth weight, CD4 cell count and HIV plasma viral load. Results The rate of repeat pregnancy among 3007 women was 16.2%. Women with a repeat pregnancy were on average younger than those with a single pregnancy (median age 30 vs. 33 years, respectively), more recently diagnosed with HIV infection (median time since diagnosis 25 vs. 51 months, respectively), and more frequently of foreign origin [odds ratio (OR) 1.36; 95% confidence interval (CI) 1.10–1.68], diagnosed with HIV infection in the current pregnancy (OR: 1.69; 95% CI: 1.35–2.11), and at their first pregnancy (OR: 1.33; 95% CI: 1.06–1.66). In women with sequential pregnancies, compared with the first pregnancy, several outcomes showed a significant improvement in the second pregnancy, with a higher rate of antiretroviral treatment at conception (39.0 vs. 65.4%, respectively), better median maternal weight at the start of pregnancy (60 vs. 61 kg, respectively), a higher rate of end-of-pregnancy undetectable HIV RNA (60.7 vs. 71.6%, respectively), a higher median birth weight (2815 vs. 2885 g, respectively), lower rates of preterm delivery (23.0 vs. 17.7%, respectively) and of low birth weight (23.4 vs. 15.4%, respectively), and a higher median CD4 cell count (+47 cells/μL), with almost no clinical progression to Centers for Disease Control and Prevention stage C (CDC-C) HIV disease (0.3%). The second pregnancy was significantly more likely to end in voluntary termination than the first pregnancy (11.4 vs. 6.1%, respectively). Conclusions Younger and foreign women were more likely to have a repeat pregnancy; in women with sequential pregnancies, the second pregnancy was characterized by a significant improvement in several outcomes, suggesting that women with HIV infection who desire multiple children may proceed safely and confidently with subsequent pregnancies.

Published
2016

7. Good prenatal detection rate of major birth defects in HIV-infected pregnant women in Italy

Author

Floridia, M, Mastroiacovo, P., Ravizza, M., Todros, T., Chiadò Fiorio Tin, M., Marconi, A. M., Cetin, I., Maruotti, G. M., Liuzzi, G., Pinnetti, C., Degli Antoni, A., Spinillo, A., Guerra, B., Tamburrini, E., Floridia, M., Mori, F., Ortolani, P., dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, Daniela, Bernini, L., Grossi, P., Rizzi, L., Alberico, S., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Roccio, M., Vimercati, A., Miccolis, A., De Gennaro, A., Cervi, F., Puccetti, C., Margarito, E., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Capone, A., Tibaldi, C., Trentini, L., Masuelli, G., Frisina, V., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rinaldi, R., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Fundarò, C., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Dalzero, S., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Parazzini, F., and Vella, S.

Subjects
Adult, Infectious, Obstetrics and Gynecology, HIV Infections, Congenital Abnormalities, Pregnancy Complications, Italy, Pregnancy, Humans, Female, Pregnancy Complications, Infectious, Genetics (clinical)
Published
2015

9. Pregnancy outcomes and cytomegalovirus DNAaemia in HIV-infected pregnant women with CMV

Author

Floridia, M., primary, Pirillo, M.F., additional, Degli Antoni, A., additional, Molinari, A., additional, Tamburrini, E., additional, Pinnetti, C., additional, Guaraldi, G., additional, Nardini, G., additional, Masuelli, G., additional, Dalzero, S., additional, Cetin, I., additional, Sansone, M., additional, Amici, R., additional, Ravizza, M., additional, Mori, F., additional, Ortolani, P., additional, dalle Nogare, E.R., additional, Di Lorenzo, F., additional, Sterrantino, G., additional, Meli, M., additional, Polemi, S., additional, Nocentini, J., additional, Baldini, M., additional, Montorzi, G., additional, Mazzetti, M., additional, Rogasi, P., additional, Borchi, B., additional, Vichi, F., additional, Del Pin, B., additional, Pinter, E., additional, Anzalone, E., additional, Marocco, R., additional, Mastroianni, C., additional, Mercurio, V.S., additional, Carocci, A., additional, Grilli, E., additional, Maccabruni, A., additional, Zaramella, M., additional, Mariani, B., additional, Natalini Raponi, G., additional, Stentarelli, C., additional, Beghetto, B., additional, Degli Antoni, A.M., additional, Crisalli, M.P., additional, Donisi, A., additional, Piepoli, M., additional, Cerri, V., additional, Zuccotti, G., additional, Giacomet, V., additional, Coletto, S., additional, Di Nello, F., additional, Madia, C., additional, Placido, G., additional, Vivarelli, A., additional, Castelli, P., additional, Savalli, F., additional, Portelli, V., additional, Sabbatini, F., additional, Francisci, D., additional, Bernini, L., additional, Grossi, P., additional, Rizzi, L., additional, Alberico, S., additional, Maso, G., additional, Airoud, M., additional, Soppelsa, G., additional, Meloni, A., additional, Dedoni, M., additional, Cuboni, C., additional, Ortu, F., additional, Piano, P., additional, Citernesi, A., additional, Bordoni Vicini, I., additional, Luzi, K., additional, Spinillo, A., additional, Roccio, M., additional, Vimercati, A., additional, Miccolis, A., additional, De Gennaro, A., additional, Guerra, B., additional, Cervi, F., additional, Simonazzi, G., additional, Margarito, E., additional, Capretti, M.G., additional, Marsico, C., additional, Faldella, G., additional, Martinelli, P., additional, Agangi, A., additional, Capone, A., additional, Maruotti, G.M., additional, Tibaldi, C., additional, Trentini, L., additional, Todros, T., additional, Frisina, V., additional, Brambilla, T., additional, Savasi, V., additional, Personeni, C., additional, Giaquinto, C., additional, Fiscon, M., additional, Rubino, E., additional, Bucceri, A., additional, Matrone, R., additional, Scaravelli, G., additional, Genovese, O., additional, Cafforio, C., additional, Liuzzi, G., additional, Tozzi, V., additional, Massetti, P., additional, Casadei, A.M., additional, Cavaliere, A.F., additional, Cellini, M., additional, Castelli Gattinara, G., additional, Marconi, A.M., additional, Sacchi, V., additional, Ierardi, M., additional, Polizzi, C., additional, Mattei, A., additional, Galluzzo, C.M., additional, Donnini, S., additional, Baroncelli, S., additional, Floridia, M., additional, Villani, P., additional, Cusato, M., additional, Cerioli, A., additional, De Martino, M., additional, Mastroiacovo, P., additional, Parazzini, F., additional, and Vella, S., additional

Published
2016
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10. Atazanavir and lopinavir profile in pregnant women with HIV: tolerability, activity and pregnancy outcomes in an observational national study

Author

Floridia, M., Ravizza, M., Masuelli, G., Giacomet, V., Martinelli, P., Degli Antoni, A., Spinillo, A., Fiscon, M., Francisci, D., Liuzzi, G., Pinnetti, C., Marconi, A. M., Tamburrini, E., Mori, F., Ortolani, P., dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, Giovanni, Nardini, Giulia, Stentarelli, Chiara, Beghetto, Barbara, Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Fabiano, V., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Bernini, L., Grossi, P., Rizzi, L., Alberico, S., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Roccio, M., Vimercati, A., Miccolis, A., Bassi, E., Guerra, B., Cervi, F., Puccetti, C., Murano, P., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Agangi, A., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Cetin, I., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Rinaldi, R., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Fundaro, C., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Dalzero, S., Sacchi, V., De Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Regazzi, M., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Moroni, M., Parazzini, F., Vella, S., Floridia, M, Ravizza, M, Masuelli, G, Giacomet, V, Martinelli, Pasquale, Degli Antoni, A, Spinillo, A, Fiscon, M, Francisci, D, Liuzzi, G, Pinnetti, C, Marconi, Am, Tamburrini, E, on behalf of The Italian Group on Surveillance on Antiretroviral Treatment in, Pregnancy, Floridia, M1, Italian Group on Surveillance on Antiretroviral Treatment in, P. r. e. g. n. a. n. c. y., Marco Floridia, Marina Ravizza, Giulia Masuelli, Vania Giacomet, Pasquale Martinelli, Anna Degli Antoni, Arsenio Spinillo, Marta Fiscon, Daniela Francisci, Giuseppina Liuzzi, Carmela Pinnetti, Anna Maria Marconi, Enrica Tamburrini, on behalf of The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy [.., Capretti, M.G., Marsico, C., Faldella, G., and ].

Subjects
Pyridines, Pyridine, HIV Infections, Triglyceride, Lopinavir, Liver Function Tests, Pregnancy, HIV Infection, Pharmacology (medical), Viral, Pregnancy Complications, Infectious, triglycerides, pre-term delivery, medicine.diagnostic_test, Liver Function Test, Obstetrics, Medicine (all), Pregnancy Outcome, Infectious, virus diseases, HIV, pregnancy, RNA, Lipid, Viral Load, Lipids, Infectious Diseases, Tolerability, Oligopeptide, Population study, RNA, Viral, Female, medicine.symptom, bilirubin, Viral load, Oligopeptides, Human, medicine.drug, Microbiology (medical), Adult, medicine.medical_specialty, HIV RNA, Anti-HIV Agents, Atazanavir Sulfate, Infectious Disease, Bilirubin, Cholesterol, Pre-term delivery, Triglycerides, Pharmacology, cholesterol, Settore MED/17 - MALATTIE INFETTIVE, medicine, Humans, business.industry, Anti-HIV Agent, medicine.disease, Atazanavir, CD4 Lymphocyte Count, Pregnancy Complications, Immunology, Pregnancy Complications, Infectiou, business, Liver function tests, Weight gain
Abstract

BACKGROUND: Atazanavir and lopinavir represent the main HIV protease inhibitors recommended in pregnancy, but comparative data in pregnant women are limited. METHODS: Women from a national observational study, exposed in pregnancy to either atazanavir or lopinavir, were compared for glucose and lipid profiles, liver function tests, CD4 count, HIV RNA and main pregnancy outcomes. Statistical methods included univariate and multivariable analyses. RESULTS: The study population included 428 pregnancies (lopinavir, 322; atazanavir, 106). The lopinavir group was characterized by higher rates of HIV diagnosis in pregnancy and treatment indication for maternal health, lower CD4 counts, higher HIV RNA levels, less frequent antiretroviral treatment at conception and shorter duration of drug exposure during pregnancy. No differences in pregnancy outcomes, glucose metabolism and weight gain were observed. The two groups also showed in a multivariable analysis similar odds for detectable HIV RNA in the third trimester (adjusted OR 0.85, 95% CI 0.35-2.10, P = 0.730). Total lipid levels were significantly higher in the lopinavir group (median values in the third trimester 239 versus 221 mg/dL for total cholesterol and 226 versus 181 mg/dL for triglycerides; P < 0.001 for both comparisons) and bilirubin levels were significantly higher in the atazanavir group (1.53 versus 0.46 mg/dL, P < 0.001). CONCLUSIONS: In this observational study atazanavir and lopinavir showed similar safety and activity in pregnancy, with no differences in the main pregnancy outcomes. Atazanavir use was associated with a better lipid profile and with higher bilirubin levels. Overall, the study findings confirm that these two HIV protease inhibitors represent equally valid alternative options.

Published
2014

11. Body Mass Index and Weight Gain in Pregnant Women With HIV: A National Study in Italy

Author

Floridia, M., Ravizza, M., Masuelli, G., Dalzero, S., Pinnetti, C., Cetin, I., Meloni, A., Spinillo, A., Rubino, E., Francisci, D., Tamburrini, E., Mori, F., Ortolani, P., Dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, Claudio Maria, Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Luzi, K., Nardini, G., Stentarelli, C., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Fabiano, V., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Bernini, L., Alberico, S., Maso, G., Tropea, M., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Vicini, I., Roccio, M., Vimercati, A., Miccolis, A., Bassi, E., Guerra, B., Cervi, F., Puccetti, C., Murano, P., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Tibaldi, C., Trentini, L., Todros, T., Garetto, S., Brambilla, T., Savasi, V., Crepaldi, A., Giaquinto, C., Fiscon, M., Rinaldi, R., Bucceri, A., Matrone, R., Scaravelli, G., Fundaro, C., Genovese, O., Cafforio, C., Liuzzi, G., Tozzi, V., Massetti, Anna Paola, Anceschi, M., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Marconi, A. M., Sacchi, V., De Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Moroni, M., Parazzini, F., Vella, S., Floridia, M, Ravizza, M, Masuelli, G, Dalzero, S, Pinnetti, C, Cetin, I, Meloni, A, Spinillo, A, Rubino, E, Francisci, D, Tamburrini, E, Italian Group on Surveillance on Antiretroviral Treatment in, Pregnancy, Martinelli, Pasquale, Floridia M, Ravizza M, Masuelli G, Dalzero S, Pinnetti C, Cetin I, Meloni A, Spinillo A, Rubino E, Francisci D, Tamburrini E, Faldella G, Guerra B, and for the Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy

Subjects
Microbiology (medical), medicine.medical_specialty, antiretroviral therapy, MEDLINE, Human immunodeficiency virus (HIV), HIV Infections, body mass index, medicine.disease_cause, Settore MED/17 - MALATTIE INFETTIVE, Body Mass Index, BMI, weight gain, HIV-1, Pregnancy, Medicine, Humans, HIV infection, pregnancy, Pregnancy Complications, Infectious, business.industry, Obstetrics, Cesarean Section, Infectious, Pregnancy Outcome, HIV, medicine.disease, Pregnancy Complications, Infectious Diseases, Italy, National study, Female, medicine.symptom, business, Weight gain, Body mass index
Abstract

Although most of the women (69.4%) had a normal BMI at start of pregnancy, only 37% had an adequate weight gain during pregnancy. Inadequate body weight gain was more common (44.8%) than excessive weight gain (18.2%), but 40% of overweight women and 50% of obese women had an excessive weight gain in pregnancy, with about 9% of the women in these categories gaining >18 kg during pregnancy (Table 1). Only 1.9% of the women had a vaginal delivery; elective and nonelective cesarean deliveries accounted for 81.3% and 16.7% of deliveries, respectively. Compared to underweight/normal women, overweight/obese women had similar occurrences of preterm delivery (23.4% vs 22.7%, P = .871), significantly lower rates of low birthweight (14.2% vs 24.2%, P = .007) and nonelective cesarean deliveries (11.7% vs 18.3%, P = .042), and a significantly higher occurrence of fasting plasma glucose >92 mg/dL at 20–28 weeks (12.1% vs 6.6%, P = .027), hypertension during pregnancy (6.4% vs 2.7%, P = .019), and gestational age–adjusted birthweight >90th percentile (15.5% vs 5.0%, P < .001). Complications of delivery, major birth defects, and HIV transmission were similar between the 2 groups (7.3% vs 7.6%, P = .881; 2.6% vs 3.5%, P = .589; and 0.8% vs 0.5%, P = .661, respectively). An inadequate weight gain during pregnancy was associated with an increased risk of nonelective cesarean delivery (OR, 1.589 [95% CI, 1.077–2.346], P = .020). Excessive weight gain during pregnancy was not associated with either hypertension (OR, 1.364 [95% CI, .537–3.465], P = .514) or 20–28 week glucose level of >92 mg/dL (OR, 0.841 [95% CI, .399–1.772], P = .648), but was significantly associated with birthweight >90th percentile (OR, 2.271 [95% CI, 1.229–4.195], P = .009), and appeared to be protective against low birthweight (OR, 0.544 [95% CI, .323–.918], P = .023) and birthweight

Published
2013

12. Body Mass Index and Weight Gain in Pregnant Women With HIV: A National Study in Italy

Author

Floridia, M, Ravizza, M, Masuelli, G, Dalzero, S, Pinnetti, C, Cetin, I, Meloni, A, Spinillo, A, Rubino, E, Francisci Dtamburrini, E, Mori, F, Ortolani, P, Dalle Nogare Er, Di Lorenzo, F, Sterrantino, G, Meli, M, Polemi, S, Nocentini, J, Baldini, M, Montorzi, G, Mazzetti, M, Rogasi, P, Borchi, B, Vichi, F, Pinter, E, Anzalone, E, Marocco, R, Mastroianni, C, Mercurio, Vs, Carocci, A, Grilli, E, Maccabruni, A, Zaramella, M, Mariani, B, Natalini Raponi, G, Guaraldi, G, Luzi, K, Nardini, G, Stentarelli, C, Degli Antoni Am, Molinari, A, Crisalli, Mp, Donisi, A, Piepoli, M, Cerri, V, Zuccotti, G, Giacomet, V, Fabiano, V, Placido, G, Vivarelli, A, Castelli, P, Savalli, F, Portelli, V, Sabbatini, F, Francisci, D, Bernini, L, Alberico, S, Maso, G, Tropea, M, Dedoni, M, Cuboni, C, Ortu, F, Piano, P, Citernesi, A, Vicini, I, Roccio, M, Vimercati, A, Miccolis, A, Bassi, E, Guerra, B, Cervi, F, Puccetti, C, Murano, P, Contoli, M, Capretti, Mg, Marsico, C, Faldella, G, Sansone, M, Martinelli, P, Agangi, A, Tibaldi, C, Trentini, L, Todros, T, Garetto, S, Brambilla, T, Savasi, V, Crepaldi, A, Giaquinto, C, Fiscon, M, Rinaldi, R, Bucceri, A, Matrone, R, Scaravelli, G, Fundarò, C, Genovese, O, Cafforio, C, Liuzzi, G, Tozzi, V, Massetti, P, Anceschi, M, Casadei, Am, Cavaliere, Af, Finelli, V, Cellini, M, Castelli Gattinara, G, Marconi, Am, Sacchi, V, De Pirro, A, Polizzi, C, Mattei, A, Pirillo, Mf, Amici, R, Galluzzo, Cm, Donnini, S, Baroncelli, S, Villani, P, Cusato, M, Cerioli, A, De Martino, Maurizio, Mastroiacovo, P, Moroni, M, Parazzini, F, Tamburrini, E, Vella, S, and Martinelli, P.

Subjects
HIV
Published
2013

13. Birth defects in a national cohort of pregnant women with HIV infection in Italy, 2001-2011

Author

Floridia, M., Mastroiacovo, P., Tamburrini, E., Tibaldi, C., Todros, T., Crepaldi, A., Sansone, M., Fiscon, M., Liuzzi, G., Guerra, B., Vimercati, A., Vichi, F., Vicini, I., Pinnetti, C., Marconi, A. M., Ravizza, M., Mori, F., Ortolani, P., dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Luzi, K., Nardini, G., Stentarelli, C., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Fabiano, V., Coletto, S., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Bernini, L., Alberico, S., Maso, G., Tropea, M., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Spinillo, A., Roccio, M., Miccolis, A., Bassi, E., Cervi, F., Puccetti, C., Murano, P., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Trentini, L., Masuelli, G., Garetto, S., Cetin, I., Brambilla, T., Savasi, V., Giaquinto, C., Rinaldi, R., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Fundaro, C., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Anceschi, M., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Dalzero, S., Sacchi, V., De Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Regazzi, M., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Moroni, M., Parazzini, F., Vella, S., Floridia, M, Mastroiacovo, P, Tamburrini, E, Tibaldi, C, Todros, T, Crepaldi, A, Sansone, M, Fiscon, M, Liuzzi, G, Guerra, B, Vimercati, A, Vichi, F, Vicini, I, Pinnetti, C, Marconi, A, Ravizza, M, Martinelli, Pasquale, and The Italian Group on Surveillance on Antiretroviral Treatment in, Pregnancy

Subjects
Male, HIV Infections, transcriptase inhibitors, Cohort Studies, chemistry.chemical_compound, Pregnancy, Prevalence, Birth Weight, Young adult, Pregnancy Complications, Infectious, education.field_of_study, Obstetrics, Coinfection, Antiretroviral therapy, birth defects, efavirenz, HIV, non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, pregnancy, protease inhibitors, women, Obstetrics and Gynecology, Abnormalities, Drug-Induced, Middle Aged, Italy, Maternal Exposure, Reverse Transcriptase Inhibitors, Female, Cohort study, Adult, medicine.medical_specialty, Efavirenz, Adolescent, Anti-HIV Agents, Birth weight, Population, Antiretroviral Therapy, Birth defects, HIV-1, Young Adult, Hepatitis B, Chronic, medicine, Humans, education, business.industry, Infant, Newborn, Odds ratio, Hepatitis C, Chronic, medicine.disease, Infectious Disease Transmission, Vertical, Surgery, Pregnancy Trimester, First, chemistry, business
Abstract

Objective We used data from a national study of pregnant women with HIV to evaluate the prevalence of congenital abnormalities in newborns from women with HIV infection. Design Observational study. Setting University and hospital clinics. Population Pregnant women with HIV exposed to antiretroviral treatment at any time during pregnancy. Methods The total prevalence of birth defects was assessed on live births, stillbirths, and elective terminations for fetal anomaly. The associations between potentially predictive variables and the occurrence of birth defects were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs) for exposed versus unexposed cases, calculated in univariate and multivariate logistic regression analyses. Main outcome measures Birth defects, defined according to the Antiretroviral Pregnancy Registry criteria. Results A total of 1257 pregnancies with exposure at any time to antiretroviral therapy were evaluated. Forty-two cases with major defects were observed. The total prevalence was 3.2% (95% CI 1.9–4.5) for exposure to any antiretroviral drug during the first trimester (23 cases with defects) and 3.4% (95% CI 1.9–4.9) for no antiretroviral exposure during the first trimester (19 cases). No associations were found between major birth defects and first-trimester exposure to any antiretroviral treatment (OR 0.94, 95% CI 0.51–1.75), main drug classes (nucleoside reverse transcriptase inhibitors, OR 0.95, 95% CI 0.51–1.76; non-nucleoside reverse transcriptase inhibitors, OR 1.20, 95% CI 0.56–2.55; protease inhibitors, OR 0.92, 95% CI 0.43–1.95), and individual drugs, including efavirenz (prevalence for efavirenz, 2.5%). Conclusions This study adds further support to the assumption that first-trimester exposure to antiretroviral treatment does not increase the risk of congenital abnormalities.

Published
2013

16. Gynaecology. Combination antiretroviral therapy in 100 HIV-1-infected pregnant women

Author

Bucceri, A.M., Somigliana, E., Matrone, R., Ferraris, G., Rossi, G., Grossi, E., and Vignali, M.

Abstract

BACKGROUND: In recent years, combination antiretroviral therapy has substantially improved the prognosis of human immunodeficiency virus type-1 (HIV-1) infection. However, at present, information regarding the effects of these regimens during pregnancy is limited. METHODS: Side-effects, vertical transmission rate and neonatal outcome associated with different combination therapies were evaluated retrospectively in a consecutive series of 100 women who attended the II Department of Obstetrics and Gynecology for the management of HIV-1 infection in pregnancy. RESULTS: Antiretroviral treatment was initiated at a median of 16 weeks gestation with a range from pre-pregnancy until 31 weeks gestation. Twentythree women continued their pre-pregnancy therapy during the first trimester of gestation. Protease inhibitors were incorporated in 23 of the final therapeutic regimens. Twentyfive women did not receive zidovudine. Most women (97) delivered by Caesarean section and none breast-fed. Prematurity rate for the entire series was 19%. When women who actively used illicit drugs were excluded, only seven of 69 (10%) women were found to deliver prematurely. The use of protease inhibitors was limited by an elevated frequency of severe gastrointestinal disturbances. The rate of congenital malformations did not appear to differ significantly from that reported in the literature for the general population. Only one of 102 live newborns was found to be HIV-1-infected (1.0%, 95% confidence interval; 0.3–4.6%). CONCLUSIONS: The present findings confirm the remarkable efficacy of combination antiretroviral therapy, Caesarean section and refraining from breast-feeding in lowering the rate of vertical HIV-1 transmission. Moreover, they are suggestive that combination antiretroviral therapy may not be related to major neonatal toxicity. The necessity to discontinue the therapy during the first trimester of pregnancy and to systematically incorporate zidovudine into combination regimens is discussed.

Published
2002

17. Consequences of presentation with advanced HIV disease in pregnancy: Data from a national study in Italy

Author

Floridia, M., Tamburrini, E., Masuelli, G., Guaraldi, G., Molinari, A., Cetin, I., Dalzero, S., Spinillo, A., Liuzzi, G., Pinnetti, C., Vicini, I., Castelli, P., Sacchi, V., Ravizza, M., Mori, F., Ortolani, P., Dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Claudio Maria MASTROIANNI, Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Raponi, G. N., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A. M., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Fabiano, V., Coletto, S., Di Nello, F., Placido, G., Vivarelli, A., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Bernini, L., Grossi, P., Rizzi, L., Alberico, S., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Vicini, I. B., Luzi, K., Roccio, M., Vimercati, A., Miccolis, A., Gennaro, A., Guerra, B., Cervi, F., Puccetti, C., Margarito, E., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rinaldi, R., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Fundarò, C., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Gattinara, G. C., Marconi, A. M., Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Cerioli, A., Martino, M., Mastroiacovo, P., Moroni, M., Parazzini, F., and Vella, S.

18. Discontinuing combination antiretroviral therapy during the first trimester of pregnancy: insights from plasma human immunodeficiency virus-1 RNA viral load and CD4 cell count

Author

Edgardo Somigliana, M Vignali, Paola Viganò, C Uberti-Foppa, R Matrone, A. Bucceri, Bucceri, Am, Somigliana, E, Matrone, R, UBERTI FOPPA, Caterina, Vigano, P, and Vignali, M.

Subjects
Adult, medicine.medical_specialty, Anti-HIV Agents, Pregnancy Trimester, Third, Virus, Drug Administration Schedule, Acquired immunodeficiency syndrome (AIDS), Obstetrics and gynaecology, Pregnancy, Internal medicine, medicine, Humans, Pregnancy Complications, Infectious, Sida, Acquired Immunodeficiency Syndrome, biology, business.industry, Obstetrics and Gynecology, Viral Load, medicine.disease, biology.organism_classification, Discontinuation, CD4 Lymphocyte Count, Pregnancy Trimester, First, Pregnancy Trimester, Second, Immunology, HIV-1, RNA, Viral, Drug Therapy, Combination, Female, Viral disease, business, Viral load
Abstract

Options for human immunodeficiency virus-1-infected women who are already receiving antiretroviral medications when they become pregnant include the continuation or discontinuation of the therapy during the first trimester. These two strategies are compared in terms of plasma human immunodeficiency virus viral load and CD4 cell count.Seventy women who attended the II Department of Obstetrics and Gynecology were identified. Four different periods for laboratory evaluations were decided: presuspension, suspension, second trimester, and third trimester.Thirty-two women (46%) discontinued antiretroviral therapy; 38 women (54%) did not. Whereas plasma HIV virus viral load and CD4 cell count did not significantly vary during pregnancy in patients who did not interrupt the therapy, these two variables were influenced significantly by the discontinuation of treatment (P.001 for both). Human immunodeficiency virus viral load increased during the suspension period and regressed promptly to basal levels as soon as the therapy was reintroduced. A transitory decrease in CD4 cell count was also documented, but the recovery tended to be slower.The suspension of combination antiretroviral therapy during the first trimester of pregnancy transiently corresponds to an increase in human immunodeficiency virus viral load and a decline of CD4 cell count.

19. A Qualitative Exploration of the Built Environment as a Key Mechanism of Safety and Social Cohesion for Youth in High-Violence Communities.

Author

Moss L, Wu K, Tucker A, Durbin-Matrone R, Roude GD, Francois S, Richardson L, and Theall KP

Subjects
Humans, Adolescent, Male, Female, Young Adult, New Orleans, Built Environment, Safety, Focus Groups, Residence Characteristics, Violence psychology, Qualitative Research
Abstract

The characteristics of a neighborhood's built environment may influence health-promoting behaviors, interactions between neighbors, and perceptions of safety. Although some research has reported on how youth in high-violence communities navigate danger, less work has investigated how these youth perceive the built environment, their desires for these spaces, and how these desires relate to their conceptions of safety and perceptions of other residents. To fill this gap, this study used focus group data from 51 youth ages 13-24 living in New Orleans, Louisiana. Four themes were developed using reflexive thematic analysis: community violence is distressing and disruptive, youth use and want to enjoy their neighborhood, systemic failure contributes to negative outcomes, and resources and cooperation create safety. This analysis indicates that young people desire to interact with the built environment despite the threat of community violence. They further identified built environment assets that facilitate socialization and recreation, such as local parks, and social assets in the form of cooperation and neighbor-led civic engagement initiatives. In addition, the youth participants demonstrated awareness of structural inequities that influence neighborhood health and violence-related outcomes. This study contributes to efforts to understand how youth with high levels of community violence exposure understand and interact with the built and social environments., (© 2024. The Author(s).)

Published
2024
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20. Liraglutide for Lower Limb Perfusion in People With Type 2 Diabetes and Peripheral Artery Disease: The STARDUST Randomized Clinical Trial.

Author

Caruso P, Maiorino MI, Longo M, Porcellini C, Matrone R, Digitale Selvaggio L, Gicchino M, Carbone C, Scappaticcio L, Bellastella G, Giugliano D, and Esposito K

Subjects
Male, Humans, Aged, Female, Liraglutide therapeutic use, Perfusion, Lower Extremity, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy, Peripheral Arterial Disease drug therapy
Abstract

Importance: Peripheral artery disease (PAD) in diabetes may lead to diabetic foot ulcer and lower-extremities amputation. Glucagon-like peptide 1 receptor agonists have proven cardiovascular benefits in trials of people with type 2 diabetes at high cardiovascular risk., Objective: To examine the effect of liraglutide on peripheral perfusion measured as peripheral transcutaneous oxygen pressure (TcPo2) in individuals with type 2 diabetes and PAD., Design, Setting, and Participants: This open-label randomized clinical trial was conducted between February 1, 2021, and June 30, 2022, with a final follow-up on December 30, 2022, at University of Campania "Luigi Vanvitelli," Naples, Italy. Fifty-five individuals with type 2 diabetes, PAD, and TcPo2 between 30 and 49 mm Hg were included., Interventions: Patients were randomized to receive 1.8 mg of subcutaneous liraglutide or conventional treatment of cardiovascular risk factors (control group) for 6 months., Main Outcomes and Measures: Coprimary outcomes were the change from baseline of peripheral perfusion between groups and the comparison of the proportion of individuals who reached 10% increase of TcPo2 from baseline in each group., Results: Fifty-five participants (mean [SD] age, 67.5 [8.5] years; 43 [78%] male) were randomized (27 to the liraglutide group and 28 to the control group) and analyzed. Participants had a median (IQR) hemoglobin A1c level of 6.9% (6.5%-7.8%) and a mean (SD) TcPo2 of 40.3 (5.7) mm Hg. Transcutaneous Po2 increased over time in both groups, with significant differences favoring the liraglutide group after 6 months (estimated treatment difference, 11.2 mm Hg; 95% CI, 8.0-14.5 mm Hg; P < .001). The 10% increase of TcPo2 occurred in 24 participants (89%) in the liraglutide group and 13 (46%) in the control group (relative risk, 1.91; 95% CI, 1.26-2.90; P < .001). Compared with the control group, individuals in the liraglutide group had a significant reduction of C-reactive protein (-0.4 mg/dL; 95% CI, -0.7 to -0.07 mg/dL; P = .02), urinary albumin to creatinine ratio (-119.4 mg/g; 95% CI, -195.0 to -43.8 mg/g; P = .003), and improvement of 6-minute walking distance (25.1 m; 95% CI, 21.8-28.3 m; P < .001)., Conclusions and Relevance: In this randomized clinical trial of people with type 2 diabetes and PAD, liraglutide increased peripheral perfusion detected by TcPo2 measurement during 6 months of treatment. These results support the use of liraglutide to prevent the clinical progression of PAD in individuals with type 2 diabetes., Trial Registration: ClinicalTrials.gov Identifier: NCT04881110.

Published
2024
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21. Biochemical predictors of diabetic foot osteomyelitis: A potential diagnostic role for parathormone.

Author

Caruso P, Maiorino MI, Scappaticcio L, Porcellini C, Matrone R, Cirillo P, Macera M, Gicchino M, Vietri MT, Bellastella G, Coppola N, and Esposito K

Subjects
Humans, Parathyroid Hormone, Alkaline Phosphatase, Diabetic Foot diagnosis, Diabetic Foot epidemiology, Osteomyelitis complications, Osteomyelitis diagnosis, Diabetes Mellitus
Abstract

Aims: The aims of this study were to evaluate parathormone (PTH) levels in people with diabetic foot ulcers (DFU) and investigate the relationship between PTH levels and osteomyelitis (OM) in this population., Materials and Methods: Eighty-eight patients were admitted for DFU in a tertiary-care centre from October 2021 to May 2022. OM was diagnosed by clinical, laboratory, and radiological evaluations. Laboratory measurements and clinical parameters were collected from medical records. Participants in the study were divided into two groups according to the diagnosis of OM (patients with OM, group 1 [n = 54] and patients without OM, group 2 [n = 34])., Results: Compared with group 2, patients in group 1 were younger and had a longer duration of diabetes. Erythrocyte sedimentation rate and fibrinogen were significantly higher in group 1 compared with group 2. PTH levels were significantly lower (group 1 vs. group 2, median [interquartile range] 16.2 (11.6, 31.0) vs. 23.7 (17.0, 38.1), p = 0.008) and alkaline phosphatase was significantly higher (97.0 (79.0, 112.0) vs. 88.0 (63.0, 107.0), p = 0.031) in group 1. In multiple linear regression analysis, the only independent predictors of PTH concentrations were alkaline phosphatase levels (β-coefficient 0.441, p < 0.001) and the presence of OM (β-coefficient -0.290, p = 0.038)., Conclusions: In a population of patients with diabetes and OM admitted to a tertiary university centre, PTH levels were lower as compared with diabetic individuals without OM. The OM and alkaline phosphatase levels were independent predictors of PTH levels in this selected population., (© 2022 John Wiley & Sons Ltd.)

Published
2023
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22. Early invasive diagnostic techniques in pregnant women who are infected with the HIV: a multicenter case series.

Author

Somigliana E, Bucceri AM, Tibaldi C, Alberico S, Ravizza M, Savasi V, Marini S, Matrone R, and Pardi G

Subjects
Adult, Anti-Retroviral Agents therapeutic use, Female, HIV Infections drug therapy, Humans, Infant, Newborn, Infectious Disease Transmission, Vertical, Pregnancy, Pregnancy Outcome, Pregnancy Trimester, Second, Amniocentesis, Chorionic Villi Sampling, Cordocentesis, HIV Infections transmission, Pregnancy Complications, Infectious
Abstract

Objective: Studies that mostly were conducted before the widespread use of combination antiretroviral treatments have reported that antenatal invasive procedures markedly increase the risk of human immunodeficiency virus vertical transmission. We aimed to evaluate the vertical transmission rate and other maternal and neonatal complications among women who were infected with human immunodeficiency virus who underwent antenatal invasive procedures during the second trimester of pregnancy and who were delivered after the advent of antiretroviral regimens., Study Design: We conducted a multicenter case series of women who were infected with human immunodeficiency virus who underwent amniocentesis or chorionic villus sampling or cordocentesis during the second trimester of pregnancy and who were delivered after January 1, 1997., Results: Sixty-three of 775 recruited women (8.1%) had performed early invasive diagnostic techniques . This rate has improved progressively from 4% in 1997 to 14%. Two of 60 viable infants (3.3%; 95% CI, 0.6%-10.1%) were infected with the human immunodeficiency virus. This rate did not differ significantly from the transmission rate that was observed in women who did not undergo antenatal invasive techniques (1.7%; P = .30)., Conclusion: The current risk of human immunodeficiency virus vertical transmission that is associated with early invasive diagnostic techniques is lower than previously reported.

Published
2005
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23. Endometriosis: novel etiopathogenetic concepts and clinical perspectives.

Author

Vignali M, Infantino M, Matrone R, Chiodo I, Somigliana E, Busacca M, and Viganò P

Subjects
Adjuvants, Immunologic therapeutic use, Animals, Anti-Inflammatory Agents therapeutic use, Aromatase Inhibitors, Endometriosis complications, Enzyme Inhibitors therapeutic use, Female, Humans, Immunity, Cellular, MEDLINE, Ovarian Cysts drug therapy, Ovarian Cysts etiology, Ovarian Diseases drug therapy, Ovarian Diseases etiology, Ovarian Neoplasms etiology, Ovarian Neoplasms genetics, Postmenopause, Raloxifene Hydrochloride therapeutic use, Rectal Diseases drug therapy, Rectal Diseases etiology, Selective Estrogen Receptor Modulators therapeutic use, Vaginal Diseases drug therapy, Vaginal Diseases etiology, Endometriosis drug therapy
Abstract

Objective: To discuss current ideas about therapy for endometriosis derived from new observations generated by using molecular biology techniques and in vivo animal models of disease., Method(s): The MEDLINE database was reviewed for English-language articles on new drugs that affect the endocrine or immunologic system, the possibility that endometriosis has multiple forms, and the association of endometriosis with cancer. Specific attention was given to in vivo studies in animals or humans., Conclusion(s): Among the novel potential candidate drugs, aromatase inhibitors and raloxifene should be considered for treatment of postmenopausal women with endometriosis. Notable observations have emerged from studies of immunomodulators and antiinflammatory agents in animal models of disease. These findings must be confirmed in women. The histogenesis of ovarian endometriomas is still unclear, thus limiting new experimental approaches to this form of disease. Given the low but established risk for malignant transformation of endometriosis, efforts should be directed toward identification of susceptibility loci for the disease and its potential transformation into cancer.

Published
2002
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24. Serum leptin concentrations in endometriosis.

Author

Viganò P, Somigliana E, Matrone R, Dubini A, Barron C, Vignali M, and di Blasio AM

Subjects
Adult, Biomarkers blood, Endometriosis pathology, Female, Humans, Middle Aged, Osmolar Concentration, Prospective Studies, Reference Values, Endometriosis blood, Endometriosis diagnosis, Leptin blood
Abstract

It has been recently reported that serum concentrations of the adipocyte-derived hormone leptin are increased in patients affected by endometriosis. On the basis of these findings, the present study was undertaken to evaluate whether the protein may be used as a new serum marker of the disease. A consecutive series of 67 reproductive-age women who underwent laparoscopy for benign gynecological pathologies were enrolled prospectively for the study. Serum leptin concentrations, as evaluated by a conventional RIA kit, were related to baseline clinical characteristics and surgical and histologic diagnosis. Endometriosis was documented in 42 women (stage I-II in 19 patients and stage III-IV in 23 patients). Twenty-five women of similar age and body mass index, who had no laparoscopic evidence of the disease, served as control group. Serum levels of leptin resulted similar between women without and with endometriosis at any stage (mean +/- SEM, 12.5 +/- 9.4 ng/ml and 12.1 +/- 8.0 ng/ml, respectively). No significant association with leptin concentrations was observed in regard to stage of the disease, number of endometriotic implants, presence/absence of an endometriotic cyst or peritoneal deep endometriosis, and presence/absence of specific symptoms. Therefore, our results do not support the possibility to employ leptin measurement as a diagnostic tool for endometriosis. Further studies are needed to elucidate the relationship between leptin and endometrial system and determine the potential contribution of the molecule in implantation and early pregnancy development.

Published
2002
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