Massimo Fioranelli
Mater Dei - Via A. Bertoloni, 34 - 00197 Roma - Tel. + 39 6 80220.1 - Fax +39 6 8084556 Italiano  Italiano   English  English 
7/30/2017 medically unexplained symptoms
1/26/2017 ecal microbiota transplantation broadening its application beyond intestinal disorders
12/21/2016 Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease
2/24/2016 The Dangers of Arterial Plaque
1/11/2016 Carnosine
1/11/2016 Discordance Between Apolipoprotein B and LDL-Cholesterol in Young Adults Predicts Coronary Artery Calcification The CARDIA Study
1/8/2016 Minimum Vitamin D Dose Inadequate For Overweight African Americans

The Health Phone ® project aims to protect the health citizens through a georeferencing system and a heart rate monitor, Health System Phone ® is able to make immediate first aid calls to 118 and send first aid instructions to the closest people.
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The Universal Universal Guide ® project implements aa universal guide on smart-phone systems or PDAs. Through the integration of multiple systems of georeferencing, Centre (RFID, Wi-Fi) and outdoor (GPS, Wi-Fi), Universal ® Guides will be able to guide disabled people also, through the principles of accessibility, within a museum, a public building, a hospital.
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The SYNTAX Score is a unique tool to score complexity of coronary artery disease.
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If you are healthy and without diabetes, the Reynolds Risk Score is designed to predict your risk of having a future heart attack, stroke, or other major heart disease in the next 10 years.
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The content on website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions.

 7/30/2017   medically unexplained symptoms   Chronic stress has been associated with autonomic nervous system-related “nonspecific” symptoms, such as palpitations, temperature dysregulation, anxiety or depressive manifestations, etc., while chronic elevations of inflammatory cytokines have been associated with also “nonspecific”, “sickness syndrome” type manifestations, such as fatigue, somnolence, nausea, hyperalgesia with varying pains and aches, dizziness, etc. . These very common clinical manifestations associated with chronic stress and inflammation bring many patients to physicians’ offices. Physicians, however, despite a full physical examination and many laboratory evaluations, fail to come up with a concrete diagnosis and the term “medically unexplained symptoms” or “MUS” has been commonly used to describe a cluster of such manifestations.

 1/26/2017   ecal microbiota transplantation broadening its application beyond intestinal disorders   Intestinal dysbiosis is now known to be a complication in a myriad of diseases. Fecal microbiota transplantation (FMT), as a microbiota-target therapy, is arguably very effective for curing Clostridium difficile infection and has good outcomes in other intestinal diseases. New insights have raised an interest in FMT for the management of extra-intestinal disorders associated with gut microbiota. This review shows that it is an exciting time in the burgeoning science of FMT application in previously unexpected areas, including metabolic diseases, neuropsychiatric disorders, autoimmune diseases, allergic disorders, and tumors. A randomized controlled trial was conducted on FMT in metabolic syndrome by infusing microbiota from lean donors or from self-collected feces, with the resultant findings showing that the lean donor feces group displayed increased insulin sensitivity, along with increased levels of butyrate-producing intestinal microbiota. Case reports of FMT have also shown favorable outcomes in Parkinson’s disease, multiple sclerosis, myoclonus dystonia, chronic fatigue syndrome, and idiopathic thrombocytopenic purpura. FMT is a promising approach in the manipulation of the intestinal microbiota and has potential applications in a variety of extra-intestinal conditions associated with intestinal dysbiosis. (World J Gastroenterology)

 12/21/2016   Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease   BACKGROUND Both genetic and lifestyle factors contribute to individual-level risk of coronary artery disease. The extent to which increased genetic risk can be offset by a healthy lifestyle is unknown. METHODS Using a polygenic score of DNA sequence polymorphisms, we quantified genetic risk for coronary artery disease in three prospective cohorts — 7814 participants in the Atherosclerosis Risk in Communities (ARIC) study, 21,222 in the Women’s Genome Health Study (WGHS), and 22,389 in the Malmö Diet and Cancer Study (MDCS) — and in 4260 participants in the cross-sectional BioImage Study for whom genotype and covariate data were available. We also determined adherence to a healthy lifestyle among the participants using a scoring system consisting of four factors: no current smoking, no obesity, regular physical activity, and a healthy diet. RESULTS The relative risk of incident coronary events was 91% higher among participants at high genetic risk (top quintile of polygenic scores) than among those at low genetic risk (bottom quintile of polygenic scores) (hazard ratio, 1.91; 95% confidence interval [CI], 1.75 to 2.09). A favorable lifestyle (defined as at least three of the four healthy lifestyle factors) was associated with a substantially lower risk of coronary events than an unfavorable lifestyle (defined as no or only one healthy lifestyle factor), regardless of the genetic risk category. Among participants at high genetic risk, a favorable lifestyle was associated with a 46% lower relative risk of coronary events than an unfavorable lifestyle (hazard ratio, 0.54; 95% CI, 0.47 to 0.63). This finding corresponded to a reduction in the standardized 10-year incidence of coronary events from 10.7% for an unfavorable lifestyle to 5.1% for a favorable lifestyle in ARIC, from 4.6% to 2.0% in WGHS, and from 8.2% to 5.3% in MDCS. In the BioImage Study, a favorable lifestyle was associated with significantly less coronary-artery calcification within each genetic risk category. CONCLUSIONS Across four studies involving 55,685 participants, genetic and lifestyle factors were independently associated with susceptibility to coronary artery disease. Among participants at high genetic risk, a favorable lifestyle was associated with a nearly 50% lower relative risk of coronary artery disease than was an unfavorable lifestyle. (Funded by the National Institutes of Health and others.) n engl j med 375;24 December 15, 2016 2349

 2/24/2016   The Dangers of Arterial Plaque   The Dangers of Arterial Plaque Cardiovascular disease remains the leading cause of death among older adults. Atherosclerosis, the thickening and narrowing of arteries, is the cumulative result of elevated cholesterol, chronic inflammation, and other factors. It leads to coronary heart disease (heart attack), stroke, and peripheral vascular disease.In recent years, we’ve developed a vastly more sophisticated understanding of the processes leading up to devastating arterial blockage by plaque lesions. Their foundation begins even before the teen years with the development of so-called fatty streaks, or regions of increased fat in the walls of arteries. At first, the small damaged fatty streak areas trigger a “healing” response, as if the streak areas were a wound, attracting inflammatory cells that ingest and store excess fats. Eventually, arterial plaquebegins to take shape as a core of fats develops outside of inflammatory cells. These plaques become less stable over time, making them more vulnerable to rupture, which leads to heart attacks and strokes. Anything we can do to slow the progression of early fatty deposits to plaque lesions is beneficial, and anything we can do stabilize these plaques makes the risk of a sudden catastrophic heart attack or stroke much less likely. Two particular supplements have been found to do just that. Pycnogenol® has been shown to slow the progression of atherosclerotic plaques. A specialized extract of Centella asiatica helps to stabilize those plaques, reducing the risk of a life-threatening rupture. Together, these two supplements can help prevent plaque progression in those with milder atherosclerosis and reduce the development of symptoms in those with more severe disease. (From LifeExtension)

 1/11/2016   Carnosine   Carnosine is a multifunctional dipeptide made up of the amino acids beta-alanine and L-histidine.58 It is found both in food and in the human body. Long-lived cells such as nerve cells (neurons) and muscle cells (myocytes) contain high levels of carnosine.58 Muscle levels of carnosine correlate with the maximum life spans of animals. Carnosine has been shown to be an anti-glycating agent. This nutrient has the ability to suppress formation of advanced glycation end products (AGEs). Carnosine levels decline with age. Muscle levels decline 63% from age 10 to age 70, which may account for the normal age-related decline in muscle mass and function. Since carnosine acts as a pH buffer, it can keep on protecting muscle cell membranes from oxidation under the acidic conditions of muscular exertion. Carnosine enables the heart muscle to contract more efficiently through enhancement of calcium response in heart myocytes. Aging causes damage to the body’s proteins. One underlying mechanism behind this damage is glycation. Glycation involves the non-enzyme controlled cross-linking of proteins or lipids and sugars to form non-functioning structures in the body. The process of glycation can be superficially seen as wrinkled skin. Glycation is also an underlying cause of age-related neurologic, vascular, and eye problems. Carnosine is a unique dipeptide that can interfere with the glycation process.

 1/11/2016   Discordance Between Apolipoprotein B and LDL-Cholesterol in Young Adults Predicts Coronary Artery Calcification The CARDIA Study  BACKGROUND High levels of apolipoprotein B (apoB) have been shown to predict atherosclerotic cardiovascular disease (CVD) in adults even in the context of low levels of low-density lipoprotein cholesterol (LDL-C) or non–highdensity lipoprotein cholesterol (non–HDL-C). OBJECTIVESThis study aimed to quantify the associations between apoB and the discordance between apoB and LDL-C or non–HDL-C in young adults and measured coronary artery calcium (CAC) in midlife. METHODSData were derived from a multicenter cohort study of young adults recruited at ages 18 to 30 years. All participants with complete baseline CVD risk factor data, including apoB and year 25 (Y25) CAC score, were entered into this study. Presence of CAC was defined as having a positive, nonzero Agatston score as determined by computed tomography. Baseline apoB values were divided into tertiles of 4 mutually exclusive concordant/discordant groups, based on median apoB and LDL-C or non–HDL-C. RESULTSAnalysis included 2,794 participants (mean age: 253.6 years; body mass index: 24.55 kg/m 2 ; and 44.4% male). Mean lipid values were as follows: total cholesterol: 177.333.1 mg/dl; LDL-C: 109.931.1 mg/dl; non–HDL-C: 124.033.5 mg/dl; HDL-C: 5312.8 mg/dl; and apoB: 90.7 24 mg/dl; median triglycerides were 61 mg/dl. Compared with the lowest apoB tertile, higher odds of developing Y25 CAC were seen in the middle (odds ratio [OR]: 1.53) and high (OR: 2.28) tertiles based on traditional risk factor–adjusted models. High apoB and low LDL-C or non–HDL-C discordance was also associated with Y25 CAC in adjusted models (OR: 1.55 and OR: 1.45, respectively). CONCLUSIONSThese data suggest a dose–response association between apoB in young adults and the presence of midlife CAC independent of baseline traditional CVD risk factors. (J Am Coll Cardiol 2016;67:193–201) © 2016 by the American College of Cardiology Foundation.

 1/8/2016   Minimum Vitamin D Dose Inadequate For Overweight African Americans   On July 4, 2015, the journal BioMed Central Obesitypublished the results of a trial of overweight and obese African Americans that revealed a failure of the Institute of Medicine’s recommended minimum daily dose of vitamin D to elevate serum levels to a healthy range after 16 weeks of treatment.* The trial included 70 overweight or obese African Americans between the ages of 13 to 45 years with 25 hydroxyvitamin D levels of 20 ng/mL or lower. Participants were randomized to groups that received a placebo or a monthly dose equivalent to 600 IU(international units), 2,000 IU, or 4,000 IUvitamin D per day for 16 weeks. While the two higher doses were successful at restoring serum vitamin D levels to 30 ng/ mLor more at 16 weeks, those who were given the lowest dose failed to achieve this level. In contrast, participants in the 2,000 and 4,000 IUequivalent group reached a serum level of 30 ng/mLas early as eight weeks. Otimal 25-hydroxyvitamin D levels are in the range of 50-80 ng/mL. * BMC Obes. 2014 Jul 4.



Fellow of European Society of Cardiology

Fellow American College of Chest Phyisicians

Member of the Society for Cardiovascular Angiography and Interventions (SCAI)

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