Papers by Cristina Bazzini
Clinical Autonomic Research, Oct 27, 2014
Italian Journal of Medicine, Mar 6, 2019
Diabetes mellitus (DM) is a very common disease, encountered in nearly one third of patients admi... more Diabetes mellitus (DM) is a very common disease, encountered in nearly one third of patients admitted to Internal Medicine Units. The discharge from the hospital is a crucial moment for patients with chronic and complex diseases such as DM and also for the caregiver. After hospital admission, therapeutic modifications with respect to usual therapy might have occurred, and shift to insulin therapy during admission occurs in the majority of patients. Therefore, treatment with insulin needs education of the patient and/or the caregiver for the correct drug administration and treatment of related side effects, mainly hypoglycemia. We believe that a very practical and mnemonic approach can help the clinician in the management of the delicate phase of hospital discharge of the diabetic patient.
High Blood Pressure & Cardiovascular Prevention, 2008
Introduction. Cardiovascular diseases are the first cause of death in the world with 80% of cardi... more Introduction. Cardiovascular diseases are the first cause of death in the world with 80% of cardiovascular events occurring in low income and middle income countries. Actions to deal with non communicable diseases require data on the prevalence of risk factor population profile which can be properly obtained in door to door epidemiological studies by using automatic instruments. This study was performed to assess sensitivity and specificity of a low cost and manage able point of care (POCT) instrument (HPS Multicare, Italy) for cholesterol and triglycerides assays. Methods. Plasma blood samples were obtained from consecutive subjects (n=300) referred to our Clinical Center for diagnostic evaluation. Imprecision profile (within-run, between-run imprecision, express ed as variation coefficient), practicability test (comparison of results obtained by non professional subjects with results carried out by professionals), and sensitivity and specificity of the device were evaluated. The comparison method was the analyzer currently used in Central Laboratory (ADVIA 1650, Siemens). Results. The within-run imprecision of the MultiCare HPS system was 2.9-7.3% and 2.5-7.4% for cholesterol and triglycerides system respectively. The between-run imprecision for cholesterol and triglycerides was 8.2-5.7% and 5.3-4.8% respectively when a control solution was used. In practicability testing, the difference of results obtained by non-professionals compared to professionals was 3.2% ± 13.3%. Sensitivity and specificity of cholesterol system using a threshold value of 160 mg/dl were 90% and 83% respectively. Sensitivity and specificity of triglycerides system using a threshold value of 170 mg/dl were 98% and 82% respectively. Conclusions. The instrument tested fulfils essential requirements of epidemiological studies. The sensitivity and specificity of Multi care Cholesterol and Triglycerides Systems as well as their diagnostic accuracy allow obtaining reliable risk profile assessment resulting in an accurate stratification of study population; the instrument maintains its reliability when used by non-professionals. Reliable POCT instruments are extremely useful in epidemiological studies performed in low-income developing countries allowing to avoid transportation and storage of biological material.
Italian Journal of Medicine, 2019
Diabetes mellitus (DM) is a very common disease, encountered in nearly one third of patients admi... more Diabetes mellitus (DM) is a very common disease, encountered in nearly one third of patients admitted to Internal Medicine Units. The discharge from the hospital is a crucial moment for patients with chronic and complex diseases such as DM and also for the caregiver. After hospital admission, therapeutic modifications with respect to usual therapy might have occurred, and shift to insulin therapy during admission occurs in the majority of patients. Therefore, treatment with insulin needs education of the patient and/or the caregiver for the correct drug administration and treatment of related side effects, mainly hypoglycemia. We believe that a very practical and mnemonic approach can help the clinician in the management of the delicate phase of hospital discharge of the diabetic patient.
Internal and Emergency Medicine, 2015
The relevance of classifying hyperglycemic hospitalized subjects (HS) as known diabetes (D), newl... more The relevance of classifying hyperglycemic hospitalized subjects (HS) as known diabetes (D), newly discovered diabetes (ND), and stress hyperglycemia (SH) is unclear. The aim of this study was to determine the prevalence, in-hospital mortality, and length of stay (LOS) of three different phenotypes of HS. Fasting glucose C126 mg/dL (7 mmol/L) or random blood glucose C200 mg/dL (11.1 mmol/L) defined HS who were categorized into three groups: D; ND (no history of diabetes and HbA1c C48 mmol/mol); SH (no history of diabetes and HbA1c \48 mmol/mol). The end points of the study were in-hospital mortality and LOS. Of 1447 consecutive enrolled subjects, the prevalence of HS was 28.6 % (415/ 1447), of these 71.6 % had D, 21.2 % SH, and 7.2 % ND, respectively. In-hospital death was 3.9 % in normoglycemic and 6.0 % in hyperglycemic subjects. Individuals with SH had an increased risk of in-hospital death (7.9 %) (HR 2.17, 95 % CI 1.18-4.9; p = 0.039), while this was not observed for D and ND patients. The mean LOS was greater in ND and SH subjects. Hyperglycemia is common, and is associated with an increased risk of in-hospital mortality and extension of hospital stay. HbA1c along with clinical history is a useful tool to identify subgroups of hyperglycemic hospitalized subjects. Individuals with SH have a longer LOS, and a double risk of in-hospital mortality. Additionally, identifying previously unknown diabetes represents a remarkable opportunity for prevention of diabetes-related acute and chronic complications.
Introduzione. Sessioni giornaliere di 30 minuti di esercizi di respirazione lenta (6atti/min) gui... more Introduzione. Sessioni giornaliere di 30 minuti di esercizi di respirazione lenta (6atti/min) guidata dalla musica inducono una diminuzione significativa della pressione arteriosa registrabile con il monitoraggio pressorio delle 24 ore. L’effetto antiipertensivo persiste a 6 mesi dall’interruzione dei cicli di trattamento. Questi dati lasciano supporre una modificazione stabile del sistema autonomo di regolazione cardiovascolare. La riduzione della frequenza respiratoria a 6 atti/min incrementa in acuto la sensibilità dei barocettori. Il presente studio è stato quindi condotto per valutare se esercizi giornalieri di respirazione lenta guidati dalla musica, possano indurre modificazioni persistenti della sensibilità dei baroriflessi in pazienti ipertesi. Materiali e metodi. Un gruppo di 22 pazienti con ipertensione essenziale di grado I (32-75anni), non in trattamento o con trattamento farmacologico stabile da almeno tre mesi, sono stati assegnati a sessioni quotidiane (30 min) di es...
Clinical Autonomic Research, 2014
Daily sessions of slow-breathing (6 breaths/min) significantly reduced 24-h ambulatory blood pres... more Daily sessions of slow-breathing (6 breaths/min) significantly reduced 24-h ambulatory blood pressure (ABP) in patients with mild hypertension and this effect persisted at least 6 months after the interruption of sessions. The sequence of changes induced by slow-breathing (SB) daily sessions on the modulation of ambulatory blood pressure, renal resistive index, heart rate variability (HRV), and baroreflex sensitivity (BRS) was thus investigated in a randomized, controlled clinical trial. Thirty-seven patients (30-75 years, grade I essential hypertension), untreated with antihypertensive drugs, were randomized to daily sessions (30 min) of music-guided SB (<10 breaths/min) (intervention, n = 24) or simple relaxation (control, n = 13). Office and ambulatory blood pressure monitoring renal Doppler ultrasound, assessment of BRS (sequence method and spectral analysis), and HRV (spectral power in the high- and low-frequency bands) were performed at baseline, and after 1, 4, and 8 weeks. Mixed model analysis was conducted on derived variables given by the difference between each measurement and the baseline value within subjects. After 1 week, the intervention enhanced the parasympathetic modulation (high-frequency power; at least p < 0.05 vs both control and baseline) and reduced renal vascular resistance (p < 0.05 for both comparisons); after 1 month, the enhancement of BRS (p < 0.05 for both comparisons at both methods) paralleled a significant reduction in 24 h ABP (p < 0.05 for all comparisons). Repeated daily session of music-guided SB increased parasympathetic modulation and decreased renal resistive index early in the study. These changes were being followed by a positive modulation of BRS and blood pressure reduction.
Translational Research, 2009
Cardiovascular disease is the leading cause of death in the world with 80% of cardiovascular even... more Cardiovascular disease is the leading cause of death in the world with 80% of cardiovascular events that occur in low-and middle-income countries. Reliable data on the prevalence of risk factors in developing countries can be obtained in doorto-door epidemiologic studies with the use of automatic instruments. This study was performed to assess the sensitivity and specificity of a low-cost and manageable point-of-care testing (POCT) instrument (HPS MultiCare-in, Italy) for cholesterol and triglyceride assays. Plasma blood samples were obtained from consecutive subjects referred to our clinic for diagnostic evaluation. The analyzer currently used in our central laboratory (ADVIA 2400; Siemens, Deerfield, Ill) was used as comparison method. The inter-assay imprecision (expressed as variation coefficient) of the MultiCare POCT system was 4.51% (range, 2.38%-8.54%) and was 3.29% (range, 1.06%-7.45%) for cholesterol and triglycerides systems, respectively. The mean percent bias for capillary samples was 3.5 6 4.3% for total cholesterol and-2.4 6 4.9% for triglycerides. The difference in results obtained by nonprofessionals compared with professionals (practicability testing) was 0.28 6 7.61% and 1.26 6 9.86%, respectively (P value was nonsignificant for both). Sensitivity and specificity measurements were 95.7% and 61.9% (threshold value of cholesterol 190 mg/dL) and 98% and 93.5% (threshold value of triglycerides 170 mg/ dL), respectively. POCT instruments are essential to perform epidemiologic studies while avoiding transportation and storage of biologic material. The characteristics of sensitivity and specificity as well as diagnostic accuracy make the POCT instrument useful for obtaining an accurate stratification of a study population.
Journal of Hypertension, 2010
Background The possibility that daily sessions of musicguided slow breathing may reduce 24-h ambu... more Background The possibility that daily sessions of musicguided slow breathing may reduce 24-h ambulatory blood pressure (ABP), and predictors of efficacy were explored in a randomized, placebo-controlled trial with parallel design. Methods Age-matched and sex-matched hypertensive patients were randomized to music-guided slow breathing exercises (4-6 breaths/min; 1 : 2 ratio of inspiration : expiration duration) (Intervention; n U 29) or to control groups who were thought to relax while either listening to slow music (Control-M; n U 26) or reading a book (Control-R; n U 31). At baseline and at follow-up visits (1 week and 1, 3 and 6 months), ABP monitoring was performed. Results At mixed model analysis, intervention was associated with a significant reduction of 24-h (P U 0.001) and night-time (0100-0600 h) (P < 0.0001) systolic ABP. The average reduction of systolic 24-h ABP at 6 months was 4.6 mmHg [confidence limits at 95% 1.93-7.35] and 4.1 mmHg (95% confidence limits 1.59-6.67) vs. Control-M and Control-R groups, respectively, (P < 0.001 for both). Antihypertensive treatment was selected as negative predictor of BP reduction at multivariate stepwise analysis. When antihypertensive treatment was inserted as covariate in a generalized linear model, psychological subscales assessed at baseline by the Mental Health Inventory questionnaire were found to affect systolic blood pressure reduction at 6-month follow-up (general positive affect P < 0.001; emotional ties, P < 0.001; loss of behavioral control, P U 0.035). In particular, a level of general positive affect higher than the 75th percentiles was found to be significantly associated with low treatment efficacy (odds ratio 0.09; 95% confidence limits 0.01-0.93). Conclusion Daily sessions of voluntary music-guided slow breathing significantly reduce 24-h systolic ABP, and psychological predictors of efficacy can be identified.
Journal of Hypertension, 2011
Anesthesiology, 2009
Background Postoperative organ dysfunction in conventional surgery for abdominal aortic aneurysm ... more Background Postoperative organ dysfunction in conventional surgery for abdominal aortic aneurysm (AAA) is associated with a complex inflammatory reaction, with activation of coagulation and fibrinolysis. A prospective,observational study was performed to define the complex plasma proteomic changes after AAA repair and to identify factor(s) that may affect myocardial function in uncomplicated procedures. Methods Ten patients undergoing infrarenal AAA repair were investigated. Eight subjects subjected to major abdominal surgery served as controls. Hemodynamic changes were continuously monitored by using the pressure recording analytical method technique. The time course of plasma proteins was investigated after induction of anesthesia and at different times after surgery (6 h, 12 h, 24 h, 36 h) by using two-dimensional difference gel electrophoresis, matrix-assisted laser desorption/ionization-time of flight mass spectrometry, and Western blot. The effects of plasma on the functional ...
Medical Mycology Case Reports, 2014
Candida glabrata is frequently resistant to fluconazole, and in advanced renal failure the safe u... more Candida glabrata is frequently resistant to fluconazole, and in advanced renal failure the safe use of this and other recommended drugs is limited. We report a case of a 56 years-old diabetic woman with renal failure and severe urinary sepsis from C. glabrata successfully treated with micafungin.
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Papers by Cristina Bazzini