Estrogen deficiency is a major cause of loss of postmenopausal bone mineral density (BMD). This s... more Estrogen deficiency is a major cause of loss of postmenopausal bone mineral density (BMD). This study aimed to evaluate the effects of equol and resveratrol on bone turnover biomarkers in postmenopausal women. Sixty healthy postmenopausal women were randomly assigned to receive 200 mg fermented soy containing 10 mg equol and 25 mg resveratrol or a placebo for 12 months. Whole-body BMD and bone turnover biomarkers, such as deoxypyridinoline (DPD), tartrate-resistant acid phosphatase 5b (TRACP-5b), osteocalcin, and bone-specific alkaline phosphatase (BAP), were measured at baseline and after 12 months of treatment. At the end of treatment, DPD, osteocalcin, and BAP significantly improved in the active group (p < 0.0001 for all) compared to the placebo group. Conversely, TRACP-5b levels were unaffected by supplementation (p = 0.051). Statistically significant changes in the concentrations of DPD (p < 0.0001), osteocalcin (p = 0.0001), and BAP (p < 0.0001) compared to baseline ...
Levodopa (L-DOPA) treatment, combined with the administration of dopa-decarboxylase inhibitors (D... more Levodopa (L-DOPA) treatment, combined with the administration of dopa-decarboxylase inhibitors (DDCIs), is still the most effective symptomatic treatment of Parkinson’s disease (PD). Although its efficacy in the early stage of the disease has been confirmed, its complex pharmacokinetics (PK) increases the variability of the intra-individual motor response, thus amplifying the risk of motor/non-motor fluctuations and dyskinesia. Moreover, it has been demonstrated that L-DOPA PK is strongly influenced by several clinical, therapeutic, and lifestyle variables (e.g., dietary proteins). L-DOPA therapeutic monitoring is therefore crucial to provide personalized therapy, hence improving drug efficacy and safety. To this aim, we have developed and validated an ultra-high performance liquid chromatography–tandem mass spectrometry (UHPLC-MS/MS) method to quantify L-DOPA, levodopa methyl ester (LDME), and the DDCI carbidopa in human plasma. The compounds were extracted by protein precipitation...
Vascular aging is linked to reduce NO bioavailability, endothelial dysfunction, oxidative stress,... more Vascular aging is linked to reduce NO bioavailability, endothelial dysfunction, oxidative stress, and inflammation. We previously showed that a 4-week treatment of middle-aged Wistar rats (MAWRs, 46 weeks old) with Moringa oleifera seed powder (MOI, 750 mg/kg/day) improved vascular function. Here, we investigated the involvement of SIRT1 in MOI-induced vascular improvement. MAWRs were treated with a standard or MOI-containing diet. Young rats (YWR, 16 weeks old) were the controls and received a standard diet. The hearts and aortas were harvested to evaluate SIRT1 and FOXO1 expression via Western blot and/or immunostaining, SIRT1 activity via a fluorometric assay, and oxidative stress using the DHE fluorescent probe. In the hearts and aortas, SIRT1 expression, reduced in MAWRs compared to YWRs, was enhanced in MOI MAWRs. In the hearts, SIRT1 activity did not differ between YWRs and MAWRs, whereas it was increased in MOI MAWRs compared with them. In the aortas, SIRT1 activity decrease...
Hand-Foot syndrome (HFS) and diarrhoea are dose-limiting Adverse Drug Reactions (ADRs) of capecit... more Hand-Foot syndrome (HFS) and diarrhoea are dose-limiting Adverse Drug Reactions (ADRs) of capecitabine-based chemotherapy. Four polymorphisms in the dihydropyrimidine dehydrogenase (DPYD) gene, encoding the DPD enzyme responsible for the metabolism of fluoropyrimidines, such as capecitabine, are strongly associated with severe ADRs, and their screening should be performed before starting treatment. Moreover, capecitabine-related toxicity may worsen due to drug-drug and drug-supplement interactions. Here we investigated factors responsible for severe HFS and diarrhoea presented by two patients, non-carriers of the recommended DPYD single nucleotide polymorphisms (SNPs) but carriers of other genetic variants suggested to increase the risk of capecitabine-related ADRs. Through careful therapy recognition, we demonstrated that, unbeknownst to the oncologists, the patients were taking folic acid during the treatment with capecitabine at a dosage higher than 2000 mg/m2, which is the maxim...
Crenotherapy is recognized as being effective in patients with osteoarthritis of the spine, but t... more Crenotherapy is recognized as being effective in patients with osteoarthritis of the spine, but to date there is no indication if it is effective for patients who are overweight or obese. The aim of this study is to evaluate the efficacy of sulphurous crenotherapy on pain and disability in overweight/obese subjects affected by chronic low back pain from spine osteoarthritis. Forty-three patients (63 ± 8.8 years) affected by chronic low back pain from lumbar spine osteoarthritis were enrolled in this study. Subjects were treated with 2 weeks of sulphurous creno-treatments. Subjective pain was measured by a numerical rating scale score (NRS), and functional mobility of the lumbar spine was measured using the Oswestry Disability Index (ODI) before and after crenotherapy. Both crenotherapy groups (normal weight: A1; overweight/obese: A2) experienced significantly improved NRS and ODI scores (A1: p < 0.001 and p = 0.001; A2: p = 0.001 and p = 0.001). At end of the treatment, significa...
Childhood obesity and its associated comorbidities are highly prevalent diseases that may add to ... more Childhood obesity and its associated comorbidities are highly prevalent diseases that may add to any other possible health problem commonly affecting the pediatric age. Uncertainties may arise concerning drug dosing when children with obesity need pharmacologic therapies. In general, in pediatric practice, there is a tendency to adapt drug doses to a child’s total body weight. However, this method does not consider the pharmacological impact that a specific drug can have under a two-fold point of view, that is, across various age and size groups as well. Moreover, there is a need for a therapeutic approach, as much as possible tailored considering relevant interacting aspects, such as modification in metabolomic profile, drug pharmacokinetics and pharmacodynamics. Taking into account the peculiar differences between children with overweight/obesity and those who are normal weight, the drug dosage in the case of obesity, cannot be empirically determined solely by the per kg criterion...
BackgroundLevodopa (LD) is the most effective drug in the treatment of Parkinson’s disease (PD). ... more BackgroundLevodopa (LD) is the most effective drug in the treatment of Parkinson’s disease (PD). Unfortunately, prolonged use of LD leads to complications, mainly motor/non-motor fluctuations (MNMF) and dyskinesias (DYS). Women seem more prone to develop such LD-related complications. Nonetheless, there is a paucity of prospective studies examining gender-related predictors of MNMF and DYS. Among several factors, which concur with a very complex scenario, changes in LD pharmacokinetics influence the drug’s effectiveness. The present study aimed to assess gender-related differences in LD pharmacokinetics in patients with PD at their first-ever intake of LD.Materials and MethodsThis is a multicentric study enrolling patients with PD, who were LD-naïve and received a single dose of LD/benserazide (100/25 mg) formulation. All participants gave their written informed consent, and the study was approved by the local Ethics Committees. To measure plasma LD concentrations and pharmacokineti...
❚ Received: April 5, 2016 Accepted: June 21, 2016 ❚ Correspondence: Graziamaria Corbi, Department... more ❚ Received: April 5, 2016 Accepted: June 21, 2016 ❚ Correspondence: Graziamaria Corbi, Department of Medicine and Health Sciences, University of Molise, via De Santis snc, 86100 Campobasso, Italy Tel. +39 087 4404771 Fax +39 087 4404728 E-mail: [email protected] Introduction. Cardiovascular diseases are very prevalent in the elderly population and characterized by high complexity, poor prognosis and comorbidity. Atrial fibrillation is common in elderly patients both in institutionalized in long-term care facilities and in community associated or not to congestive heart failure, but the management with anticoagulant oral therapy is highly variable and problematic. Case presentation. Here we describe a case report on a patient treated with amiodarone and heparine for acute atrial fibrillation episodes. Three years before he underwent partial intestinal resection for bowel cancer. During Warfarin therapy a treatment with neomycin sulphate/bacitracin was started. After three d...
INTRODUCTION Low back pain is one of the most frequent causes of consultation of the General Prac... more INTRODUCTION Low back pain is one of the most frequent causes of consultation of the General Practitioner (GP). The purpose of the present study is to analyze the therapeutic management of low back pain, in relation to pain intensity, in the primary care setting and to assess its impact on the patient's quality of life. METHODS From the computerized medical records of 65 GPs, all working in the Salerno province (South of Italy), data concerning non-cancer subjects affected by low back or sciatica pain, over 18 years, who consulted the GP in the period between February 1, 2015 and January 31, 2016, were extracted. Pain intensity and quality of life were reported using the 0-10 numeric rating scale (NRS) and the EQ-5D instruments, respectively. RESULTS A total of 2555 subjects were identified: 28.7% reported mild pain (NRS 0-3), 55.6% moderate pain (NRS 4-6) and 15.7% severe pain (NRS 7-10). Only 35% of patients received a prescription for pain therapy (24.5% in mild pain; 34.1% i...
In traditional geriatrics, the study and treatment of diseases follow the same criteria of genera... more In traditional geriatrics, the study and treatment of diseases follow the same criteria of general medicine, i.e., the diseases are first of all divided according to the affected anatomical or functional system. For example, in the Broklehurst’s Textbook of Geriatric Medicine and Gerontology (Fillit et al. 2017), the subject is divided into the sections Cardiovascular system, Respiratory system, Nervous system, Musculoskeletal system, Gastroenterology, Urinary tract, Women’s health, Endocrinology, Hematology and Oncology, Skin and Special senses, which mirrors the division of general medicine into various specializations.
Background: Pharmacogenetics investigates the response to pharmacological treatments based on ind... more Background: Pharmacogenetics investigates the response to pharmacological treatments based on individual genetic background. Actually, numerous pharmacogenetic tests help to predict the response to drugs used in different medical areas, contributing to the so-called personalized medicine. Objective: This review aims to update the available data on the genotype-guided treatment with both the anticoagulant and antiplatelet agents. Moreover, it shed light on the pitfalls still contrasting the implementation of cardiovascular pharmacogenetics. Methods: A review of the literature on the studies investigating the effects of the genotype-guided anticoagulant and antiplatelet treatment was performed. Results: Considering the large use of antithrombotic drugs, pharmacogenetics has particular importance in this field. Several polymorphisms influence the response to both anticoagulant and antiplatelet agents, and tests, based on their identification, are now available. Conclusions: Recent rand...
Estrogen deficiency is a major cause of loss of postmenopausal bone mineral density (BMD). This s... more Estrogen deficiency is a major cause of loss of postmenopausal bone mineral density (BMD). This study aimed to evaluate the effects of equol and resveratrol on bone turnover biomarkers in postmenopausal women. Sixty healthy postmenopausal women were randomly assigned to receive 200 mg fermented soy containing 10 mg equol and 25 mg resveratrol or a placebo for 12 months. Whole-body BMD and bone turnover biomarkers, such as deoxypyridinoline (DPD), tartrate-resistant acid phosphatase 5b (TRACP-5b), osteocalcin, and bone-specific alkaline phosphatase (BAP), were measured at baseline and after 12 months of treatment. At the end of treatment, DPD, osteocalcin, and BAP significantly improved in the active group (p < 0.0001 for all) compared to the placebo group. Conversely, TRACP-5b levels were unaffected by supplementation (p = 0.051). Statistically significant changes in the concentrations of DPD (p < 0.0001), osteocalcin (p = 0.0001), and BAP (p < 0.0001) compared to baseline ...
Levodopa (L-DOPA) treatment, combined with the administration of dopa-decarboxylase inhibitors (D... more Levodopa (L-DOPA) treatment, combined with the administration of dopa-decarboxylase inhibitors (DDCIs), is still the most effective symptomatic treatment of Parkinson’s disease (PD). Although its efficacy in the early stage of the disease has been confirmed, its complex pharmacokinetics (PK) increases the variability of the intra-individual motor response, thus amplifying the risk of motor/non-motor fluctuations and dyskinesia. Moreover, it has been demonstrated that L-DOPA PK is strongly influenced by several clinical, therapeutic, and lifestyle variables (e.g., dietary proteins). L-DOPA therapeutic monitoring is therefore crucial to provide personalized therapy, hence improving drug efficacy and safety. To this aim, we have developed and validated an ultra-high performance liquid chromatography–tandem mass spectrometry (UHPLC-MS/MS) method to quantify L-DOPA, levodopa methyl ester (LDME), and the DDCI carbidopa in human plasma. The compounds were extracted by protein precipitation...
Vascular aging is linked to reduce NO bioavailability, endothelial dysfunction, oxidative stress,... more Vascular aging is linked to reduce NO bioavailability, endothelial dysfunction, oxidative stress, and inflammation. We previously showed that a 4-week treatment of middle-aged Wistar rats (MAWRs, 46 weeks old) with Moringa oleifera seed powder (MOI, 750 mg/kg/day) improved vascular function. Here, we investigated the involvement of SIRT1 in MOI-induced vascular improvement. MAWRs were treated with a standard or MOI-containing diet. Young rats (YWR, 16 weeks old) were the controls and received a standard diet. The hearts and aortas were harvested to evaluate SIRT1 and FOXO1 expression via Western blot and/or immunostaining, SIRT1 activity via a fluorometric assay, and oxidative stress using the DHE fluorescent probe. In the hearts and aortas, SIRT1 expression, reduced in MAWRs compared to YWRs, was enhanced in MOI MAWRs. In the hearts, SIRT1 activity did not differ between YWRs and MAWRs, whereas it was increased in MOI MAWRs compared with them. In the aortas, SIRT1 activity decrease...
Hand-Foot syndrome (HFS) and diarrhoea are dose-limiting Adverse Drug Reactions (ADRs) of capecit... more Hand-Foot syndrome (HFS) and diarrhoea are dose-limiting Adverse Drug Reactions (ADRs) of capecitabine-based chemotherapy. Four polymorphisms in the dihydropyrimidine dehydrogenase (DPYD) gene, encoding the DPD enzyme responsible for the metabolism of fluoropyrimidines, such as capecitabine, are strongly associated with severe ADRs, and their screening should be performed before starting treatment. Moreover, capecitabine-related toxicity may worsen due to drug-drug and drug-supplement interactions. Here we investigated factors responsible for severe HFS and diarrhoea presented by two patients, non-carriers of the recommended DPYD single nucleotide polymorphisms (SNPs) but carriers of other genetic variants suggested to increase the risk of capecitabine-related ADRs. Through careful therapy recognition, we demonstrated that, unbeknownst to the oncologists, the patients were taking folic acid during the treatment with capecitabine at a dosage higher than 2000 mg/m2, which is the maxim...
Crenotherapy is recognized as being effective in patients with osteoarthritis of the spine, but t... more Crenotherapy is recognized as being effective in patients with osteoarthritis of the spine, but to date there is no indication if it is effective for patients who are overweight or obese. The aim of this study is to evaluate the efficacy of sulphurous crenotherapy on pain and disability in overweight/obese subjects affected by chronic low back pain from spine osteoarthritis. Forty-three patients (63 ± 8.8 years) affected by chronic low back pain from lumbar spine osteoarthritis were enrolled in this study. Subjects were treated with 2 weeks of sulphurous creno-treatments. Subjective pain was measured by a numerical rating scale score (NRS), and functional mobility of the lumbar spine was measured using the Oswestry Disability Index (ODI) before and after crenotherapy. Both crenotherapy groups (normal weight: A1; overweight/obese: A2) experienced significantly improved NRS and ODI scores (A1: p < 0.001 and p = 0.001; A2: p = 0.001 and p = 0.001). At end of the treatment, significa...
Childhood obesity and its associated comorbidities are highly prevalent diseases that may add to ... more Childhood obesity and its associated comorbidities are highly prevalent diseases that may add to any other possible health problem commonly affecting the pediatric age. Uncertainties may arise concerning drug dosing when children with obesity need pharmacologic therapies. In general, in pediatric practice, there is a tendency to adapt drug doses to a child’s total body weight. However, this method does not consider the pharmacological impact that a specific drug can have under a two-fold point of view, that is, across various age and size groups as well. Moreover, there is a need for a therapeutic approach, as much as possible tailored considering relevant interacting aspects, such as modification in metabolomic profile, drug pharmacokinetics and pharmacodynamics. Taking into account the peculiar differences between children with overweight/obesity and those who are normal weight, the drug dosage in the case of obesity, cannot be empirically determined solely by the per kg criterion...
BackgroundLevodopa (LD) is the most effective drug in the treatment of Parkinson’s disease (PD). ... more BackgroundLevodopa (LD) is the most effective drug in the treatment of Parkinson’s disease (PD). Unfortunately, prolonged use of LD leads to complications, mainly motor/non-motor fluctuations (MNMF) and dyskinesias (DYS). Women seem more prone to develop such LD-related complications. Nonetheless, there is a paucity of prospective studies examining gender-related predictors of MNMF and DYS. Among several factors, which concur with a very complex scenario, changes in LD pharmacokinetics influence the drug’s effectiveness. The present study aimed to assess gender-related differences in LD pharmacokinetics in patients with PD at their first-ever intake of LD.Materials and MethodsThis is a multicentric study enrolling patients with PD, who were LD-naïve and received a single dose of LD/benserazide (100/25 mg) formulation. All participants gave their written informed consent, and the study was approved by the local Ethics Committees. To measure plasma LD concentrations and pharmacokineti...
❚ Received: April 5, 2016 Accepted: June 21, 2016 ❚ Correspondence: Graziamaria Corbi, Department... more ❚ Received: April 5, 2016 Accepted: June 21, 2016 ❚ Correspondence: Graziamaria Corbi, Department of Medicine and Health Sciences, University of Molise, via De Santis snc, 86100 Campobasso, Italy Tel. +39 087 4404771 Fax +39 087 4404728 E-mail: [email protected] Introduction. Cardiovascular diseases are very prevalent in the elderly population and characterized by high complexity, poor prognosis and comorbidity. Atrial fibrillation is common in elderly patients both in institutionalized in long-term care facilities and in community associated or not to congestive heart failure, but the management with anticoagulant oral therapy is highly variable and problematic. Case presentation. Here we describe a case report on a patient treated with amiodarone and heparine for acute atrial fibrillation episodes. Three years before he underwent partial intestinal resection for bowel cancer. During Warfarin therapy a treatment with neomycin sulphate/bacitracin was started. After three d...
INTRODUCTION Low back pain is one of the most frequent causes of consultation of the General Prac... more INTRODUCTION Low back pain is one of the most frequent causes of consultation of the General Practitioner (GP). The purpose of the present study is to analyze the therapeutic management of low back pain, in relation to pain intensity, in the primary care setting and to assess its impact on the patient's quality of life. METHODS From the computerized medical records of 65 GPs, all working in the Salerno province (South of Italy), data concerning non-cancer subjects affected by low back or sciatica pain, over 18 years, who consulted the GP in the period between February 1, 2015 and January 31, 2016, were extracted. Pain intensity and quality of life were reported using the 0-10 numeric rating scale (NRS) and the EQ-5D instruments, respectively. RESULTS A total of 2555 subjects were identified: 28.7% reported mild pain (NRS 0-3), 55.6% moderate pain (NRS 4-6) and 15.7% severe pain (NRS 7-10). Only 35% of patients received a prescription for pain therapy (24.5% in mild pain; 34.1% i...
In traditional geriatrics, the study and treatment of diseases follow the same criteria of genera... more In traditional geriatrics, the study and treatment of diseases follow the same criteria of general medicine, i.e., the diseases are first of all divided according to the affected anatomical or functional system. For example, in the Broklehurst’s Textbook of Geriatric Medicine and Gerontology (Fillit et al. 2017), the subject is divided into the sections Cardiovascular system, Respiratory system, Nervous system, Musculoskeletal system, Gastroenterology, Urinary tract, Women’s health, Endocrinology, Hematology and Oncology, Skin and Special senses, which mirrors the division of general medicine into various specializations.
Background: Pharmacogenetics investigates the response to pharmacological treatments based on ind... more Background: Pharmacogenetics investigates the response to pharmacological treatments based on individual genetic background. Actually, numerous pharmacogenetic tests help to predict the response to drugs used in different medical areas, contributing to the so-called personalized medicine. Objective: This review aims to update the available data on the genotype-guided treatment with both the anticoagulant and antiplatelet agents. Moreover, it shed light on the pitfalls still contrasting the implementation of cardiovascular pharmacogenetics. Methods: A review of the literature on the studies investigating the effects of the genotype-guided anticoagulant and antiplatelet treatment was performed. Results: Considering the large use of antithrombotic drugs, pharmacogenetics has particular importance in this field. Several polymorphisms influence the response to both anticoagulant and antiplatelet agents, and tests, based on their identification, are now available. Conclusions: Recent rand...
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