Cardiovascular diseases in Paralympic athletes.

Background: Sport participation (SP) of individuals with impairments has recently grown exponentially. Scarce scientific data, however, exist regarding cardiovascular (CV) risk associated with competitive SP.

Objective: Assessing the prevalence of CV abnormalities and the risk for SP in Paralympic athletes (PA).

Benign clinical significance of J-wave pattern (early repolarization) in highly trained athletes.

Background: J wave/QRS slurring (early repolarization) on 12-lead ECG has been associated with increased risk for ventricular fibrillation in the absence of cardiovascular (CV) disease.

Objective: The purpose of this study was to assess the prevalence and clinical significance of J wave/QRS slurring in a large population of competitive athletes.

Methods: Seven hundred four athletes (436 males [62%], age 25 ± 5 years) free of CV disease who had engaged in 30 different sports were examined.

Knowledge about health effects of cigarette smoking and quitting among Italian university students: the importance of teaching nicotine dependence and treatment in the medical curriculum.

Aims of the study were to compare medical students (MS) to non-MS with respect to their knowledge of smoking and to investigate the effect of a short educational intervention on MS knowledge. MS (n = 962) and students of architecture and law (n = 229) were asked to complete a 60-item questionnaire addressing knowledge of smoking epidemiology and health effects ("Score 1"), and effectiveness of cessation treatments ("Score 2"). Upon completion of questionnaire, fourth year MS received a lecture on tobacco dependence.

Validity of the Italian version of the Severity of Dependence Scale (SDS) for nicotine dependence in smokers intending to quit.

The objective was to test the psychometric properties of an Italian version of the Severity of Dependence Scale, a five-item measure designed to assess the compulsive dimension of drug dependence. 635 smokers enrolled in a tobacco dependence treatment program served as the participants. The Fagerström Test for Nicotine Dependence was used as a comparative measure.

Higher clusterin immunolabeling and sperm DNA damage levels in hypertensive men compared with controls.

Background: Clusterin, a heterodimeric glycoprotein found at several sites in the human male reproductive tract, could be a marker of morphologically abnormal spermatozoa, while TUNEL positivity indicates DNA fragmentation. Metabolic disorders such as diabetes mellitus and obesity may compromise sperm quality and fertility of men; however, little evidence specifically links hypertension with the impairment of male reproductive function.

Methods: By flow cytometric, immunofluorescence (TUNEL assay and clusterin immunolabeling) and immunohistochemical (peroxidase-streptavidin method) analyses, we have compared both clusterin- and TUNEL labeling in ejaculated spermatozoa from healthy normotensive donors and hypertensive subjects with the purpose to reveal possible differences between the two conditions.

3-T Diffusion tensor imaging of the optic nerve in subjects with glaucoma: correlation with GDx-VCC, HRT-III and Stratus optical coherence tomography findings.

Objectives: To correlate diffusion-tensor imaging (DTI) of the optic nerve with morphological indices obtained by scanning laser polarimetry (GDx-VCC); confocal scanning laser ophthalmoscopy (Heidelberg III retinal tomograph; HRT-III) and optical coherence tomography (Stratus OCT).

Methods: Thirty-six subjects (12 with no eye disease and 24 with perimetrically diagnosed glaucoma) were examined. One eye for each participant was studied with 3-Tesla DTI (with automatic generation of mean diffusivity (MD) and fractional anisotropy (FA) values); GDx-VCC, HRT-III and OCT.

The athlete's heart in adolescent Africans: an electrocardiographic and echocardiographic study.

Objectives: The goal of this study was to define electrocardiographic (ECG) and echocardiographic characteristics of adolescent African athletes.

Background: Recent observations in African athletes reported large prevalence of left ventricular (LV) hypertrophy and ECG abnormalities. No data, so far, exist for adolescent Africans, which comprise a growing proportion of competitive/professional athletes.

Cigarette smoking knowledge and perceptions among students in four Italian medical schools.

Introduction: Tobacco smoking is the leading cause of premature death in the developed world. Advice and assistance by physicians help smokers quit, but little attention has been paid to the topic of tobacco dependence in the curricula of Italian medical schools. Consequently, few physicians follow the clinical practice guidelines for treating dependence.

Low-volume plus ascorbic acid vs high-volume plus simethicone bowel preparation before colonoscopy.

Aim: To investigate the effectiveness of low-volume plus ascorbic acid [polyethylene glycol plus ascorbic acid (PEG + Asc)] and high-volume plus simethicone [polyethylene glycol plus simethicone (PEG + Sim)] bowel preparations.

Methods: A total of one hundred and forty-four outpatients (76 males), aged from 20 to 84 years (median age 59.5 years), who attended our Department, were divided into two groups, age and sex matched, and underwent colonoscopy.

Left ventricular systolic performance is improved in elite athletes.

Aims: We sought to investigate the systolic time interval (STI) and efficiency of left ventricular (LV) contraction comparatively in elite athletes and healthy sedentary controls by means of three-dimensional echocardiography (3DE).

Methods And Results: Four hundred and twenty-nine elite athletes, involved in skill (n = 41), power (n = 63), mixed (n = 167), and endurance (n = 158) disciplines and 98 sedentary controls, matched for age, underwent 3DE. By off-line analysis, we measured the absolute and relative (normalized by the R-R interval) timing of LV systolic emptying (STI and STI%) and the systolic flow velocity (SFV = stroke volume/STI).

Three-dimensional echocardiographic characterization of left ventricular remodeling in Olympic athletes.

The aim of the present study was to assess, using 3-dimensioanl echocardiography, the morphologic characteristics, determinants, and physiologic limits of left ventricular (LV) remodeling in 511 Olympic athletes (categorized in skill, power, mixed, and endurance sport disciplines) and 159 sedentary controls matched for age and gender. All subjects underwent 3-dimensional echocardiography for the assessment of LV volumes, ejection fraction, mass, remodeling index (LV mass/LV end-diastolic volume), and systolic dyssynchrony index (obtained by the dispersion of the time to minimum systolic volume in 16 segments). Athletes had higher LV end-diastolic volumes (157 ± 35 vs 111 ± 26 ml, p <0.

Patterns of ventricular tachyarrhythmias associated with training, deconditioning and retraining in elite athletes without cardiovascular abnormalities.

Ventricular tachyarrhythmias commonly occur in trained athletes during ambulatory Holter electrocardiography and are usually associated with a benign course. Such arrhythmias have been demonstrated to be sensitive to short periods of athletic deconditioning; however, their response to retraining is not known. Twenty-four hour Holter electrocardiographic monitoring was performed at peak training and after 3 to 6 months of deconditioning and was repeated in the present study after 2, 6, and 12 months of retraining in 37 athletes with frequent and complex ventricular tachyarrhythmias and without cardiovascular abnormalities.

The 12-year incidence of glaucoma and glaucoma-related visual field loss in Italy: the Ponza eye study.

Purpose: To assess the 12-year incidence of glaucoma and glaucoma-related visual field loss in a population-based cohort study.

Patients: In 2000, we reexamined 411 of the 581 survivors from the original Ponza eye study conducted in 1988.

Methods: Primary open-angle (POAG), primary angle-closure (PACG), and secondary [pseudoexfoliative (PEX)] glaucoma were diagnosed according to the 3-tiered system of evidence developed by the International Society of Geographical and Epidemiological Ophthalmology.

First salivary screening of celiac disease by detection of anti-transglutaminase autoantibody radioimmunoassay in 5000 Italian primary schoolchildren.

Objective: The high prevalence of celiac disease (CD) prompted us to evaluate a new, noninvasive disease screening strategy. The aim was to identify CD in 6- to 8-year-old children for a timely diagnosis, start gluten-free diet (GFD) in compliant subjects, achieve the growth target, and prevent CD complications.

Methods: Five thousand subjects were invited to participate in the study.

Prevalence and clinical significance of aortic root dilation in highly trained competitive athletes.

Background: Few data are available that address the impact of athletic training on aortic root size. We investigated the distribution, determinants, and clinical significance of aortic root dimension in a large population of highly trained athletes.

Methods And Results: Transverse aortic dimensions were assessed in 2317 athletes (56% male), free of cardiovascular disease, aged 24.

Long-term clinical consequences of intense, uninterrupted endurance training in olympic athletes.

Objectives: The aim of this study was to assess incidence of cardiac events and/or left ventricular (LV) dysfunction in athletes exposed to strenuous and uninterrupted training for extended periods of time.

Background: Whether highly intensive and uninterrupted athletic conditioning over a long period of time might be responsible for cardiac events and/or LV dysfunction is unresolved.

Methods: We assessed clinical profile and cardiac dimensions and function in 114 Olympic athletes (78% male; mean age 22 +/- 4 years), free of cardiovascular disease, participating in endurance disciplines, who experienced particularly intensive and uninterrupted training for 2 to 5 consecutive Olympic Games (total, 344 Olympic events), over a 4- to 17-year-period (mean 8.

Treatment of erectile dysfunction due to C677T mutation of the MTHFR gene with vitamin B6 and folic acid in patients non responders to PDE5i.

Introduction: Epidemiological studies conducted on erectile dysfunction (ED) have demonstrated its close correlation with cardiovascular disease. Since hyperhomocysteinemia is considered an important cardiovascular risk factor, it could also be involved in the pathogenesis of ED.

Aim: To study the role of the C677T MTHFR mutation with subsequent hyperhomocysteinemia in the determination of ED.

Nationwide incidence of endophthalmitis among the general population and the subjects at risk of endophthalmitis in Italy.

Purpose: To investigate the incidence of endophthalmitis in Italy.

Methods: The Ministry of Health Hospital Admissions online database was searched to identify cases of endophthalmitis and cases with risk factors for endophthalmitis (corneal ulcer, open wound of the eyeball, and intraocular surgery including retinal, iris, and lens procedures with or without vitrectomy). Annual Incidence rates (overall, and age- and gender-specific) were computed in the general population and in the population with one or more of the risk factors for endophthalmitis.

Relation between training-induced left ventricular hypertrophy and risk for ventricular tachyarrhythmias in elite athletes.

The aim of this study was to analyze the relation between the magnitude of training-induced left ventricular (LV) hypertrophy and the frequency and complexity of ventricular tachyarrhythmias in a large population of elite athletes without cardiovascular abnormalities. Ventricular tachyarrhythmias are a common finding in athletes, but it is unresolved as to whether the presence or magnitude of LV hypertrophy is a determinant of these arrhythmias in athletes without cardiovascular abnormalities. From 738 athletes examined at a national center for the evaluation of elite Italian athletes, 175 consecutive elite athletes with 24-hour ambulatory (Holter) electrocardiographic recordings (but without cardiovascular abnormalities and symptoms) were selected for the study group.

Age-specific changes in the prevalence and management of optically correctable visual impairment between 1988 and 2000: the Ponza Eye Study.

Purpose: To obtain age-specific data on changes in the prevalence and management of optically correctable visual impairments (OCVIs) in Ponza, Italy.

Methods: Ophthalmologic examinations were carried out to 1000 Ponzans aged 40-87 years in 1988 and to 836 persons in 2000. Visual acuity (VA) was evaluated under uncorrected (VA(UC)), presenting (VA(PR)), and best-corrected (VA(BC)) conditions.

Outcomes in athletes with marked ECG repolarization abnormalities.

Background: Young, trained athletes may have abnormal 12-lead electrocardiograms (ECGs) without evidence of structural cardiac disease. Whether such ECG patterns represent the initial expression of underlying cardiac disease with potential long-term adverse consequences remains unresolved. We assessed long-term clinical outcomes in athletes with ECGs characterized by marked repolarization abnormalities.

Age-specific changes in the prevalence of best-corrected visual impairment in an italian population.

Purpose: To investigate changes in the prevalence of visual impairment in an Italian population from 1988 to 2000.

Methods: Standardized ophthalmologic examinations were administered to citizens of Ponza, Italy aged 40-87 years in 1988 and 2000. Visual Acuity (VA) was measured using a standard logarithmic chart.

Prevalence of abnormal electrocardiograms in a large, unselected population undergoing pre-participation cardiovascular screening.

Aims: The implementation of 12-lead ECG in the pre-participation screening of young athletes is still controversial and number of issues are largely debated, including the prevalence and spectrum of ECG abnormalities found in individuals undergoing pre-participation screening.

Methods And Results: We assessed a large, unselected population of 32,652 subjects [26 050 (80%) males], prospectively examined in 19 clinics associated to Italian Sports Medicine Federation. Most were young amateur athletes, aged 8-78 years (median 17), predominantly students (68%), engaged predominantly in soccer (39%), volleyball or basketball (8% each), athletics (6%), cycling (5%), swimming (4%).

Effect of chemo- or radiotherapy on sperm parameters of testicular cancer patients.

Background: The aims of our study were to investigate the short- and long-term effects of chemo- or radiotherapy on spermatogenesis in patients with testicular cancer and to establish any correlation between pre-therapy sperm parameters, histotype and treatment type/intensity and the progress of spermatogenesis during the post-therapy period.

Methods: We evaluated 166 patients affected by testicular cancer, who cryobanked about 1 month after the removal of the cancerous testis and before beginning chemo- (CH group; n = 71) or radiotherapy (RT group; n = 95).

Results: For the CH group, there was a statistically significant decrease in sperm parameters, which was most significant 3 months after the end of chemotherapy.