Luca Giupponi

Metabolic syndrome in human immunodeficiency virus-positive subjects: prevalence, phenotype, and related alterations in arterial structure and function.

BACKGROUND Human immunodeficiency virus (HIV) infection itself and highly active antiretroviral treatment (HAART) have been proposed to be associated with a higher prevalence of metabolic syndrome, but, to date, prevalence and phenotype of metabolic syndrome among HIV subjects and the related structural and functional vascular alterations are not conclusively defined. METHODS We analyzed the data of 108 HIV-infected subjects without known cardiovascular risk factors: 72 were on HAART (group A, age 46.5±7.5 years, clinical blood pressure 125.7/74.9±11.6/7.8 mmHg) and there 36 in a naïve group (group B, age 40.7±7.9 years, blood pressure 126/75.8±9.8/7.7 mmHg). A total of 224 healthy subjects served as controls (group C, age 44.9±6.9 years, blood pressure 123.7/75.7±9.8/7.1 mmHg). Arterial stiffness was measured by aorto-femoral pulse wave velocity (PWV, sfigmocor), and carotid intima media thickness (IMT) was measured by a semiautomatic echotracking system (Esaote-WTS). RESULTS Metabolic syndrome was more frequent in HIV-positive subjects than in controls (19.4%, 13.8%, 4.5% for groups A, B, and C; P<0.001), with no significant difference between HAART and naïve. In metabolic syndrome subjects, group A displayed lipid profile alterations more frequently (91%, 50%, 57% for groups A, B, and C; P<0.05), whereas others metabolic syndrome components were equally represented in the three groups. In metabolic syndrome subjects, IMT was similar [556±108, 542±164, and 564±110.4 μm for groups A, B, and C; P=not significant (NS)], whereas PWV was significantly greater in HAART subjects when compared with controls (10.8±1.8, 9.±1.1, 9.3±1 cm/sec for groups A, B, and C; P=0.02 for A vs. C). Moreover, in this group (metabolic syndrome+HAART), PWV was higher than in subjects on HAART but without metabolic syndrome. CONCLUSIONS HIV subjects showed a higher prevalence and a different pattern of metabolic syndrome components. HAART, more than HIV infection per se, appeared to be responsible for the increased prevalence of metabolic syndrome and arterial function derangement.

Structural and Functional Abnormalities of Carotid Artery and Their Relation with EVA Phenomenon

Early vascular aging is a process characterized by a reduction in arterial elastin with an increase in collagen that has been related to cardiovascular risk factor and can determine an increased arterial stiffness and central blood pressure. It can be measured by several non invasive methods and in different arterial segment. The present paper will focus on functional (local stiffness parameter) and structural (intima media thickness) carotid arteries alterations typically evaluated by ultrasound methods. Methodological, research and clinical issue has been reviewed.

A proposal for assessing the success of soil bioengineering work by analysing vegetation: results of two case studies in the Italian Alps

The evaluation of the success of soil bioengineering work is an issue still poorly addressed by the scientific community. Nevertheless, soil bioengineering techniques are increasingly used worldwide when mitigating the impact on the environment and the landscape is one, but not the only, goal of intervention. A tool to measure the success of soil bioengineering work, with reference to landslide stabilization, is presented in this paper: the index of ecological success (IES). The IES is based on the phytosociological analysis of vegetation and widens the potential applications of the ecological index of maturity (EIM), recently formulated by Giupponi et al. (Restor Ecol 23:635–644, 2015) to assess the degree of disturbance affecting a plant community. The IES compares the EIM values of the vegetation of an area affected by soil stabilization work with those of the expected vegetation at a precise time after completion of soil stabilization work, providing values ranging between 0 (maximum failure) and 1 (complete success). The IES was applied in two study areas located on two mountain slopes of the Southern Alps (Italy) which, as a result of landslides, were subject to soil bioengineering work aimed at slope stabilization. The results of these first two applications confirm the efficacy of the IES in evaluating the success of soil bioengineering work in mountain areas and bode well as to its future application.

Effectiveness of fine root fingerprinting as a tool to identify plants of the Alps: Results of a preliminary study

Abstract To identify plants of the Alps through analysis of their roots is currently extremely difficult when using traditional identification methods such as dichotomous keys and/or illustrated atlases. Besides genetic analysis, other analytical methods, such as chromatographic analysis, could also be useful for root identification. Chromatographic fingerprints of root extracts of six species (Betula pendula, Picea abies, Fagus sylvatica, Larix decidua, Fraxinus excelsior and Corylus avellana) were analyzed in order to understand whether these species have a chromatographic fingerprint that identifies them, and hence to ascertain whether they can be identified by applying the method of analysis presented below. One hundred and sixty-two root samples were collected in various areas of the Alps and subjected to high-performance liquid chromatography (HPLC) analysis. Multivariate analysis techniques (e.g. cluster analysis) were employed for statistical analysis of chromatographic fingerprints. This study revealed that the chromatographic fingerprints of birch, spruce and larch samples were similar and that the method can therefore clearly identify the respective species. Instead, chromatographic fingerprint samples of beech, hazel and ash presented greater variability. Research proposals based on the results obtained in this study were also developed in order to implement and facilitate studies regarding plant roots.

Prospects for Broader Cultivation and Commercialization of Copafam, a Local Variety of Phaseolus coccineus L., in the Brescia Pre-Alps

The conservation and enhancement of agrobiodiversity have been promoted by local, national, and international institutions over the last few decades. In the context of that effort, this study focused on a little-known endangered landrace grown in the Brescia pre-Alps in Northern Italy: Copafam, a variety of runner bean (Phaseolus coccineus L.). The agronomic characteristics of plants and the bromatological features of seeds harvested in 7 experimental fields, set up at different elevations in Northern Italy, were analyzed. Results showed that this landrace is most suitable for cultivation at higher elevations. As elevation increased from 110 to 1100 m above sea level, the plants became more vigorous and productive and the beans became larger and more digestible. This research not only increases knowledge of the specific landrace but can also serve as an example and stimulus for efforts to safeguard agrobiodiversity worldwide, because it suggests a number of strategies for the conservation and valorization of this particular mountain variety using existing legal and economic mechanisms for protecting agrobiodiversity.

Quality Traits of “Cannabidiol Oils”: Cannabinoids Content, Terpene Fingerprint and Oxidation Stability of European Commercially Available Preparations

Cannabidiol (CBD)-based oil preparations are becoming extremely popular, as CBD has been shown to have beneficial effects on human health. CBD-based oil preparations are not unambiguously regulated under the European legislation, as CBD is not considered as a controlled substance. This means that companies can produce and distribute CBD products derived from non-psychoactive hemp varieties, providing an easy access to this extremely advantageous cannabinoid. This leaves consumers with no legal quality guarantees. The objective of this project was to assess the quality of 14 CBD oils commercially available in European countries. An in-depth chemical profiling of cannabinoids, terpenes and oxidation products was conducted by means of GC-MS and HPLC-Q-Exactive-Orbitrap-MS in order to improve knowledge regarding the characteristics of CBD oils. Nine out of the 14 samples studied had concentrations that differed notably from the declared amount, while the remaining five preserved CBD within optimal limits. Our results highlighted a wide variability in cannabinoids profile that justifies the need for strict and standardized regulations. In addition, the terpenes fingerprint may serve as an indicator of the quality of hemp varieties, while the lipid oxidation products profile could contribute in evaluation of the stability of the oil used as milieu for CBD rich extracts.

How to renew soil bioengineering for slope stabilization: some proposals

Mountain environments play a crucial role in maintaining biodiversity despite becoming more vulnerable to colluvial processes primarily induced by extreme meteorological events. Soil bioengineering stabilizes mountain slopes and limits impacts on ecosystems and is increasingly used worldwide, yet its effectiveness requires better assessment through post-intervention environmental monitoring. However such studies are only rarely performed even though they are essential to improve future intervention. This study reports soil and vegetation monitoring data of an area in the Italian Alps in which soil bioengineering work was carried out to restore an area hit by landslides. The monitoring involved an analysis of the floristic-vegetational and ecological features of the plant communities of the area of the soil bioengineering intervention (and in adjacent areas), as well as an analysis of the chemical–physical characteristics of the soils (texture, pH, organic matter, nitrogen content, roots depth) where these communities were established. The results of the monitoring, analyzed in the overall framework of the state of the art of the sector, have highlighted some lines of research and action that should be undertaken by technicians, researchers, and politicians to innovate and to make work aimed at the stabilization of landslides more effective. In particular, it would be extremely useful to study the biotechnical characteristics of herbaceous plants that are still “unknown” in soil bioengineering and to evaluate their possible effects on ecosystems in order to produce seed mixtures that, besides being useful for soil stabilization, can accelerate vegetation dynamics, therefore maximizing the success of such works.

Determinants of carotid-femoral pulse wave velocity progression in hypertensive patients over a 3.7 years follow-up

Abstract Objective: The role of risk factors on the progression of arterial stiffness has not yet been extensively evaluated. The aim of the current longitudinal study was to evaluate the determinants of the PWV progression over a 4 years follow-up period in hypertensive subjects. Materials and Methods: We enrolled 333 consecutive hypertensive outpatients 18–80 aged, followed by the Hypertension Unit of St. Gerardo Hospital (Monza, Italy). At baseline anamnestic, clinical, BP, laboratory data and cfPWV were assessed. We performed a PWV follow-up examination with a median time amounting to 3.75 ± 0.53 years. Results: At baseline the mean age was 54.5 ± 12.6 years, SBP and DBP were 141.3 ± 18.6 and 86.4 ± 10.4 mmHg and PWV was 8.56 ± 1.92 m/s. Despite an improvement in BP control (from 37 to 60%), at follow-up the population showed a PWV increase (ΔPWV 0.87 ± 3.05 m/s). PWV and ΔPWV gradually increased in age decades. In patients with uncontrolled BP values at follow-up ΔPWV showed a greater increase as compared to patients with controlled BP (1.46 ± 3.67 vs 0.62 ± 2.61 m/s, p < .05). The independent predictors of ΔPWV were age, baseline PWV, baseline SBP/MBP and ΔSBP/MBP. Conclusions: the accelerated arterial aging in treated hypertensive subjects is in large measure explained by age and BP values. PWV changes over time would probably give important information that need further future research studies.

Quality traits of saffron (Crocus sativus L.) produced in the Italian Alps

Abstract Saffron (Crocus sativus L.) is a perennial herbaceous geophyte in the Iridaceae family. It propagates vegetatively by corm. All saffron production processes are generally conducted by hand: from bulb implantation, harvesting of flowers to stigma separation. Saffron is the most expensive spice in the world because of the intensive hand labour required for production. The increasing interest in Crocus sativus cultivation and production in the Italian Alpine area could increase revenues for the rural farming economy. Twenty eight dried saffron samples were collected from different farmers of the Italian Alpine area (Lombardia, Trentino Alto Adige, Piemonte and Veneto) between November 2015 and March 2016. Each sample was processed to determine their moisture content and amount of picrocrocin, crocins and safranal using the methods established by the International Organization for Standardization for saffron (ISO 3632 1,2:2010-2011). Over 82.1 % of the samples analyzed were ranked in the highest quality category of the ISO 3632. A high quality saffron product can be produced in the Italian Alpine area suggesting that this crop could serve as a sustainable source of economic revenues to diversified farms in the Alps.

Delayed, severe thrombocytemia after abciximab infusion for primary angioplasty in acute coronary syndromes: Moving between systemic bleeding and stent thrombosis

Abciximab is a platelet glycoprotein (GP) IIb/IIIa receptor blocker used, in association with other antiplatelet and anticoagulant drugs, during high-risk percutaneous coronary intervention (PCI) in the setting of acute coronary syndromes (ACS). Administration of abciximab is associated with development of thrombocytopenia [1]. In approximately one-third of patients, thrombocytopenia is a laboratory artefact (pseudothrombocytopenia) [2]. Immune-mediated thrombocytopenia, either acute (4–96 hours from drug exposure) or delayed (5–8 days) is also well recognised [3–8]. While the acute form is secondary to naturally occurring cross-reacting antibodies, the delayed form reflects an immune response to a neo-antigen resulting from abciximab being bound to the platelet membrane; platelets sensitized by the antibody are cleared from the circulation mainly by splenic macrophages [9]. The immune response is drug-dependent and therefore thrombocytopenia is self-limiting, resolving with clearance of abciximab from the blood stream and bone marrow production of new platelets [7]. Delayed thrombocytopenia has been described following a drug regimen of abciximab bolus plus 12-hour infusion after PCI [10, 11]. It usually follows an uneventful course and its detection is occasional [9]. We present two patients who developed severe delayed abciximab-induced thrombocytopenia while on prasugrel, a P2Y12 blocker that has been associated with increased risk of bleeding events [12], whose clinical picture was that of an emergency situation due to the coexisting risk of stent thrombosis and of severe bleeding. Case 1: A 46-year-old man presented with large anterior STsegment elevation myocardial infarction (STEMI) secondary to occlusion of the proximal left anterior descending artery which was treated by PCI using three bare metal stents. A single periprocedural bolus of abciximab (0.25 mg/kg) was administrated along with 5000 UI of unfractionated heparin. Dual antiplatelet therapy (DAPT) – aspirin and prasugrel – was initiated in the cathlab. Platelet count at admission and discharge were 276 and 220 10/l, respectively. Eight days after PCI, the patient was readmitted to the emergency room for petechiae and significant gingival bleeding; platelet count was 1 10/l. DAPT was discontinued, a platelet pool was transfused and dexamethasone was administered. Because of high risk of stent thrombosis, the patient was admitted to the Intensive Cardiac Care Unit (ICCU) for monitoring. Prompt response to platelet transfusion was observed ruling out ITP and steroids were discontinued. Platelet kinetics are depicted in Figure 1(A), along with instituted therapy. Aspirin was resumed on day 9, and prasugrel on day 10. At discharge (day 14 from PCI), platelet counts had returned to normal levels (168 10/l); subsequent follow-up was uneventful. Case 2: A 50-year-old man presented with infero-posterolateral STEMI secondary to occlusion of the mid circumflex artery which was treated by PCI using a drug-eluting stent. Abciximab (bolus followed by 12-hour infusion 0.125 mcg/kg/ min) was administrated along with 5000 UI of unfractionated heparin. DAPT – aspirin and clopidogrel – was initiated in the cathlab. Platelet count at admission was 232 10/l, and remained stable over the next 5 days. On day 4, prasugrel was substituted for clopidogrel. On day 6, acute severe thrombocytopenia (platelet count of 1 10/l) developed not associated with bleeding signs. The patient was transferred to the ICCU for monitoring. DAPT was discontinued, platelet transfusion every 12 hours and dexamethasone were started. Platelet kinetics are depicted in Figure 1(B), along with instituted therapy. Aspirin was resumed on day 9, and prasugrel on day 10. At discharge (day 13 from PCI), platelet counts had returned to normal levels (146 10/l); subsequent follow-up was uneventful. Although seldom characterized by severe (i.e. platelet count 520 10/l) thrombocytopenia, delayed abciximab-induced Keywords