0000000000007419
AUTHOR
Pierpaolo Baiamonte
Different immunohistochemical levels of Hsp60 and Hsp70 in a subset of brain tumors and putative role of Hsp60 in neuroepithelial tumorigenesis
In this work we analysed, by immunohistochemistry, a series of brain tumors to detect the levels and cellular distribution of Hsp60 and Hsp70. We found that Hsp60 levels were significantly higher than those of Hsp70 in neuroepithelial tumors, while levels of both molecules were not significantly different from each other in meningeal neoplasms. In particular, Hsp60 immunopositivity was present mainly at the cytoplasmic level, while Hsp70 immunopositivity was found both in the cytoplasm and in the nucleus of tumor cells. The levels of these molecules in healthy control cells were always very low. Finally, Hsp60 and Hsp70 levels did not correlate with the different types (WHO grade) of neopla…
Environmental Conditions, Air Pollutants, and Airways
Air pollution is a major problem worldwide, which could be even more serious for athletes who train in urban environments. Exercise increases minute ventilation and exposure to pollutants, but the literature on the effects of air pollution in athletes is relatively scarce, with the exception of chlorine exposure in athletes of aquatic sports and air pollution secondary to ice resurfacing in athletes performing in ice arenas. Although air pollution may exert detrimental effects on athletic performance, little has been published on this topic. The largest body of information regards the impact of air pollution during urban active transport, i.e., walking and cycling in cities, due to the pote…
Sleep Disturbances in COPD are Associated with Heterogeneity of Airway Obstruction
Individuals with Chronic Obstructive Pulmonary Disease (COPD) experience sleep disturbances due to the impact of respiratory symptoms on sleep quality. We explored whether sleep disturbances in COPD are linked to heterogeneity of airway constriction.The impact of breathing problems on sleep quality was measured in consecutive COPD outpatients with the COPD and Asthma Sleep Impact Scale (CASIS) questionnaire. Impulse oscillometry technique (IOS) was employed to assess heterogeneity of airway constriction. Subjects with a previous or concomitant diagnosis of asthma or obstructive sleep apnea (OSA) were excluded.Fifty COPD subjects (M/F 40/10; age: 71 +/- 8 yrs, Body Mass Index (BMI): 26.2 +/-…
Compliance to ventilatory treatment in a cohort of patients on home CPAP or NIV: analysis by diagnosis, treatment type, and comorbidities
Background: Patients on home continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) show large variability in compliance to treatment. Aim: To identify predictors of poor compliance, we evaluated compliance to treatment in patients with obstructive sleep apnea (OSA), obesity hypoventilation syndrome (OHS), and OSA-chronic obstructive pulmonary disease (COPD) overlap syndrome. Methods: We analyzed clinical and compliance data provided by a single home care provider, in 602 patients (n=442 OSA, males (M) 308; 38 OHS M=15, and 122 overlap M=111) on home CPAP/NIV in the province of Agrigento, Italy, after one year of treatment. The following variables were considered: age, …
Automatic bilevel ventilation in sleep-disordered breathing: A real-life experience in southern Italy
Automatic bilevel ventilation (AutoBI) has been recently introduced to treat obstructive sleep-disordered breathing (SDB), but clinical experience is still limited. We revised the charts of patients treated for obstructive SDB in our sleep clinic in 2015 (n=214) to assess the frequency of trials of AutoBI ventilators (ResMed Auto25 or Respironics BiFlex), the clinical characteristics of these patients, the reason to shift from CPAP to AutoBI, and the outcome of AutoBI titration. A trial of domiciliary AutoBI was made in 44 patients (20.5%) intolerant to CPAP due to high CPAP levels (n=11) or who showed incomplete resolution of SDB on CPAP (n=33). The table reports the clinical data accordin…
Relationship between sleep disturbances and peripheral airway abnormalities in COPD patients
Background: Individuals with COPD experience sleep disturbances due to the impact of symptoms on quality of sleep. Aim: To test the hypothesis that, in COPD, sleep disturbances are linked to peripheral airway abnormalities. Methods: An investigational study is being performed at the University of Palermo, Italy. The impact of breathing problems on quality of sleep during the previous week is measured with the COPD and Asthma Sleep Impact Scale (CASIS) questionnaire. Airway resistances by impulse oscillometry (IOS) assesses peripheral airway abnormalities. Lung function evaluation includes static and dynamic lung volume measurements. To rule out the risk of having obstructive sleep apnea, th…
Use of autobilevel ventilation in patients with obstructive sleep apnea: An observational study.
Continuous positive airway pressure (CPAP) is the first-choice treatment for obstructive sleep-disordered breathing. Automatic bilevel ventilation can be used to treat obstructive sleep-disordered breathing when CPAP is ineffective, but clinical experience is still limited. To assess the outcome of titration with CPAP and automatic bilevel ventilation, the charts of 356 outpatients (obstructive sleep apnea, n = 242; chronic obstructive pulmonary disease + obstructive sleep apnea overlap, n = 80; obesity hypoventilation syndrome [OHS], n = 34; 103 females) treated for obstructive sleep-disordered breathing from January 2014 to April 2017 were reviewed. Positive airway pressure titration was …
Prescription of automatic bilevel ventilation (AutoBI) in sleep-disordered breathing: analysis according to diagnosis and occurrence of comorbidities
CPAP is the first-choice treatment for obstructive sleep-disordered breathing (O-SDB), while the criteria to prescribe AutoBI are undefined. Trials of AutoBI ventilation in patients (pts) treated for O-SDB from January 2015 to October 2016 (64 out of 242 titrations) were reviewed to assess: a) the clinical characteristics of these pts, b) the reason to shift from CPAP to AutoBI, c) the compliance to prescribed treatment. AutoBI was used in cases of intolerance to high therapeutic CPAP levels (n=21) or incomplete resolution of SDB on CPAP (n=43). The Table reports the differences between CPAP or AutoBI pts CPAP SDB diagnosis was: 82% OSA, 18% OSA-COPD Overlap in the CPAP group; 39% OSA, 28% …
Endurance training: Is it bad for you?
Educational aims To illustrate the characteristics of endurance exercise training and its positive effects on health. To provide an overview on the effects of endurance training on airway cells and bronchial reactivity. To summarise the current knowledge on respiratory health problems in elite athletes. Endurance exercise training exerts many positive effects on health, including improved metabolism, reduction of cardiovascular risk, and reduced all-cause and cardiovascular mortality. Intense endurance exercise causes mild epithelial injury and inflammation in the airways, but does not appear to exert detrimental effects on respiratory health or bronchial reactivity in recreational/non-eli…
Sleep disordered breathing in patients with cardiovascular comorbidities hospitalized for pulmonary disease
Sleep disordered breathing (SDB) is often overlooked in hospitalized patients. We screened consecutive patients with cardiovascular (CV) comorbidities hospitalized for respiratory problems to study SDB prevalence and type. Patients did not refer typical clinical signs of SDB. Patients (n=34, 21 M, mean age±SD 71±12 yr, BMI: 31.9±5.8 kg/m2) were studied by polygraphy (SomnoLab, Weinmann, Germany) 4.5±3.2 days after admission for COPD exacerbation (COPD-E, n=20), pleural effusion (n=2), asthma exacerbation (n=2) or other causes (n=10). On admission, 18 patients showed respiratory failure (RF, hypoxemic: n=9, hypercapnic: n=9). CV comorbidities (1.7±0.8/patient) were: hypertension (n= 27), hea…
Obstructive sleep apnea and comorbidities: a dangerous liaison
Obstructive sleep apnea (OSA) is a highly prevalent disease, and is traditionally associated with increased cardiovascular risk. The role of comorbidities in OSA patients has emerged recently, and new conditions significantly associated with OSA are increasingly reported. A high comorbidity burden worsens prognosis, but some data suggest that CPAP might be protective especially in patients with comorbidities. Aim of this narrative review is to provide an update on recent studies, with special attention to cardiovascular and cerebrovascular comorbidities, the metabolic syndrome and type 2 diabetes, asthma, COPD and cancer. Better phenotypic characterization of OSA patients, including comorbi…
Automatic bilevel ventilation (AutoBI) in obstructive sleep-disordered breathing (SDB): clinical features and compliance to treatment
CPAP is the first-choice treatment for obstructive SDB, but the criteria to prescribe AutoBI are undefined. Trials of AutoBI ventilation in patients under titration for obstructive SDB from January 2015 to January 2017 ((n=67 out of 265 titrations) were reviewed to assess: a) their clinical features, b) the reason to shift from CPAP to AutoBI, and c) long-term compliance to treatment. AutoBI was used in cases of intolerance to high therapeutic CPAP levels (n=23) or incomplete resolution of SDB on CPAP (n=45). AutoBI failed in 11 patients (16.4%): 2 OSA patients (7.7%), 4 overlap patients (21%), and 5 OHS patients (22.7%). The Table reports the differences at diagnosis between patients presc…