COLLEGIO DI DIREZIONE - Azienda Ospedaliera di Parma

Eighty-three percent of patients were infected with hepatitis C virus (HCV) and 22% of them were also co-infected with
human immunodeficiency virus (HIV). Forty-three percent of cancers were HCV-related, whereas 9% were HIVrelated.
Virus-related cancers were more frequent and non-virus-related cancers less frequent in patients with severe hemophilia
than in those with mild/moderate forms (P = 0.0004). The non-virus-related standardized mortality ratio (SMR) was 0.3.
Hemorrhagic complications occurred more frequently in patients undergoing chemotherapy (14%) or radiotherapy
(19%). Conclusions: The results of the present study confirm that cancers have become a new challenge for physicians
working in hemophilia centers and underline the need for prospective trials to better assess the epidemiology and to
optimize the management of hemophiliacs with cancer.
81) Targher, G; Pichiri, I; Lippi, G (2012) Vitamin D, Thrombosis, and Hemostasis: More than Skin Deep
SEMINARS IN THROMBOSIS AND HEMOSTASIS 38(1):114-123 IF=4.169 [Article]
Vitamin D-3 deficiency is a highly prevalent condition worldwide. Clinically, vitamin D-3 has a key role in calcium
homeostasis and bone mineralization and has recently been implicated in the pathogenesis and/or progression of several
acute and chronic illnesses, including cardiovascular disease (CVD). Accumulating evidence from observational,
prospective studies suggests that low levels of serum 25-hydroxyvitamin D-3 are independently associated with an
increased risk of CVD events and death. The molecular mechanisms of this association remain incompletely
understood. A variety of biologically plausible mechanisms may mediate a cardiovascular role for the active metabolite
of vitamin D-3. 1-alpha, 25-dihydroxyvitamin D-3 regulates the renin-angiotensin system, suppresses proliferation of
vascular cell smooth muscle, improves insulin resistance and endothelial cell-dependent vasodilation, inhibits
myocardial cell hypertrophy, exerts anticoagulant and antifibrotic activity, and modulates macrophage activity and
cytokine generation. Overall, the high prevalence of vitamin D-3 deficiency and the plausible biological mechanisms
linking this to CVD risk suggest that the treatment of vitamin D-3 deficiency to prevent CVD is a promising field to
explore. Large placebo-controlled randomized clinical trials are urgently needed to determine whether vitamin D
supplementation could have any potential benefit in reducing future CVD events and mortality risk.
82) Tedeschi, S; Pilotti, E; Parenti, E; Vicini, V; Coghi, P; Montanari, A; Regolisti, G; Fiaccadori, E;
Cabassi, A (2012) Serum adipokine zinc alpha 2-glycoprotein and lipolysis in cachectic and noncachectic
heart failure patients: relationship with neurohormonal and inflammatory biomarkers METABOLISM-
CLINICAL AND EXPERIMENTAL 61(1):37-42 IF=2.538 [Article]
Chronic heart failure is often complicated by the development of cachexia with the loss of fat mass. Zinc alpha 2glycoprotein
(ZAG) is a serum adipokine with lipolytic effects in cancer cachexia. We evaluated in patients with
advanced heart failure with (CxHF) or Without cachexia (nCxHF) the relationship of ZAG with circulating free fatty
acid (FFA), as an index of lipolysis, and with other neurohormonal and inflammatory biomarkers. Two groups, nCxHF
(n = 46) and CxHF (n = 18), the latter having a documented, involuntary, edema-free loss of body weight of at least
7.5% in the previous 6 months, underwent plasma determination of FFA, ZAG, norepinephrine (NE), tumor necrosis
factor-alpha, and natriuretic peptide levels (atrial natriuretic, B-type natriuretic peptide). The patients were compared
with age-matched healthy controls (CTR) (n = 21). Zinc alpha 2-glycoprotein, atrial natriuretic peptide, B-type
natriuretic peptide, and tumor necrosis factor-alpha circulating levels were similarly greater in CxHF and nCxHF than
in CTR. Free fatty acid and NE were higher in CxHF than in nCxHF. A positive correlation between FFA and NE was