Distal outpatients hemodynamic treatment of chronic venous insufficiency of the lower limbs: a new proposal.

The etiology of the venous insufficiency of the lower limbs is related to the increase of the district pressure. This occurs in case of pressure overload of the afferent compartment with a progressive increase of the gradient until the reversal of the flow direction. Varicose veins would be the effect and not the cause of the pressure overload which must always be researched in the efferent (draining) compartment. The gradient inversion in a compartment causes a reflux circuit (venous shunt) only if - in addition to the escape point - one re-entry point is also active, The closure of the escape point does not solve the etiological moment of the district pressure overload. It is therefore a symptomatic treatment that cannot reduce the potential of the system to cause recurrences. During walking, reflux will cause Transmural Pressure Peaks (PPT): in diastole if the reflux is systolic; in systole if the reflux is diastolic; in diastole and in systole if the reflux is diastolic-systolic. On this basis, it has been proposed CHIVA 2 distal outpatient treatment without CHIVA 1 with interesting haemodynamic effects. In the subcutaneous area by the pressure overload block it improves compartment drainage, reduces the peak of trans-mural pressure and the caliber of the varicose veins. In the intrafascial district: reduces peak and trans-mural walking pressure; does not change the drainage of the reflux; can restore an antegrade flow. KEY WORDS: Hemodyamic venous treatment, Vricose veins, Venous Hemodynamic Map (VHM).

A Feasibility Study towards the On-Line Quality Assessment of Pesto Sauce Production by NIR and Chemometrics.

The food industry needs tools to improve the efficiency of their production processes by minimizing waste, detecting timely potential process issues, as well as reducing the efforts and workforce devoted to laboratory analysis while, at the same time, maintaining high-quality standards of products. This can be achieved by developing on-line monitoring systems and models. The present work presents a feasibility study toward establishing the on-line monitoring of a pesto sauce production process by means of NIR spectroscopy and chemometric tools. The spectra of an intermediate product were acquired on-line and continuously by a NIR probe installed directly on the process line. Principal Component Analysis (PCA) was used both to perform an exploratory data analysis and to build Multivariate Statistical Process Control (MSPC) charts. Moreover, Partial Least Squares (PLS) regression was employed to compute real time prediction models for two different pesto quality parameters, namely, consistency and total lipids content. PCA highlighted some differences related to the origin of basil plants, the main pesto ingredient, such as plant age and supplier. MSPC charts were able to detect production stops/restarts. Finally, it was possible to obtain a rough estimation of the quality of some properties in the early production stage through PLS.

How Chemometrics Can Fight Milk Adulteration.

Adulteration and fraud are amongst the wrong practices followed nowadays due to the attitude of some people to gain more money or their tendency to mislead consumers. Obviously, the industry follows stringent controls and methodologies in order to protect consumers as well as the origin of the food products, and investment in these technologies is highly critical. In this context, chemometric techniques proved to be very efficient in detecting and even quantifying the number of substances used as adulterants. The extraction of relevant information from different kinds of data is a crucial feature to achieve this aim. However, these techniques are not always used properly. In fact, training is important along with investment in these technologies in order to cope effectively and not only reduce fraud but also advertise the geographical origin of the various food and drink products. The aim of this paper is to present an overview of the different chemometric techniques (from clustering to classification and regression applied to several analytical data) along with spectroscopy, chromatography, electrochemical sensors, and other on-site detection devices in the battle against milk adulteration. Moreover, the steps which should be followed to develop a chemometric model to face adulteration issues are carefully presented with the required critical discussion.

Characterization of Basil Volatile Fraction and Study of Its Agronomic Variation by ASCA.

Basil is a plant known worldwide for its culinary and health attributes. It counts more than a hundred and fifty species and many more chemo-types due to its easy cross-breeds. Each species and each chemo-type have a typical aroma pattern and selecting the proper one is crucial for the food industry. Twelve basil varieties have been studied over three years (2018-2020), as have four different cuts. To characterize the aroma profile, nine typical basil flavour molecules have been selected using a gas chromatography-mass spectrometry coupled with an olfactometer (GC-MS/O). The concentrations of the nine selected molecules were measured by an ultra-fast CG e-nose and Principal Component Analysis (PCA) was applied to detect possible differences among the samples. The PCA results highlighted differences between harvesting years, mainly for 2018, whereas no observable clusters were found concerning varieties and cuts, probably due to the combined effects of the investigated factors. For this reason, the ANOVA Simultaneous Component Analysis (ASCA) methodology was applied on a balanced a posteriori designed dataset. All the considered factors and interactions were statistically significant (p < 0.05) in explaining differences between the basil aroma profiles, with more relevant effects of variety and year.

LC-HRMS for Characterizing Durum Wheat Pasta Production Variability and Consumer Overall Liking.

Semolina pasta represents one of the most important dishes in Italian cuisine worldwide. Italy is the leader in its production and, recently, the worldwide diffusion of its production has begun to grow tremendously. The perceived quality of a food product, such as pasta, is a key feature that allows a company to increase and maintain the competitive advantage of a specific brand. The overall flavor perception of the consumer, therefore, has become as important as other key quality factors such as texture and color; thus, the food industry needs to meet consumer expectations and needs the tools to objectively "measure" the quality of food products. Untargeted fingerprinting by means of coupling LC with high-resolution MS (HRMS) has been well received within the analytical community, and different studies exploiting this approach for the characterization of high-value food products have recently been reported in the literature. In the present work, a tentative application of the sensomics approach to cluster analysis of semolina pasta obtained using different production conditions was developed to objectively define target molecules that correlate with consumer overall liking of an industrial standard product. Principal component analysis of chemical and physical testing, GC-MS, LC-HRMS, and sensory data were performed with the aim of identifying the main parameters to discern similarities and differences among samples and clustering them according to these features. The correlation between analytical data and compounds related to sensory data was further investigated, and lastly, a partial least-squares regression model for the prediction of consumer overall liking was reported.

Echocolor Doppler morpho-functional study of the jugulo-subclavian confluence in chronic cerebro-spinal venous insufficiency and multiple sclerosis patients.

OBJECTIVES: The aim of this work is to measure the mean diameter of the confluence jugulo- subclavian, the impact of different types of jugular confluences and the correlation between the types of confluences and the Valsalva maneuver (jugular reflux) in subjects with Chronic Cerebro-Spinal Venous Insufficiency (CCSVI) and Multiple Sclerosis. METHOD: We investigated by Echo-Color-Doppler (ECD) 103 subjects (67 F 36M) of mean age 45 ± 12 years (a minimum of 22 to a maximum of 79 years, with a median of 44 and a modal value 42 years), mean EDSS of 4.7 and average disease duration of 12 years. RESULTS: The 103 right jugular veins investigated had an average diameter of 8.4 ± 2.4 mm (minimum 4.0, maximum 14.9 mm; median 7.9; modal value 7.6 mm). Three form types were found: 56 cylindrical, 29 conical and 18 funnel. Valsalva maneuver was positive in 30 patients. The 103 left jugular investigated had an average diameter of 8.9 ± 2.4 mm (minimum 2.8, maximum 14.4 mm; median of 8.8; modal value 8.7 mm). The form types were found: 42 cylindrical, 45 conical and 16 funnel. Valsalva maneuver was positive in 30 patients. CONCLUSIONS: The mean diameter of the jugular veins was 8.7 mm. Internal jugular veins with cylindrical morphology have a diameter smaller than other forms; this difference is statistically significant. The different morphology of the jugular vein confluence does not increase the possibility of a reflux because the positive Valsalva maneuvers are not statistically significant when compared to the various types. KEY WORDS: CCSVI, EchoColorDoppler Map, Jugulo-Subclavian Confluence Diameter.

Venous compression syndrome of internal jugular veins prevalence in patients with multiple sclerosis and chronic cerebro-spinal venous insufficiency.

OBJECTIVES: Analysis of the incidence of Venous Compression Syndrome (VCS) with full block of the flow of the internal jugular veins (IJVs) in patients with Multiple Sclerosis and Chronic cerebro-spinal venous insufficiency. METHODS: We included 769 patients with MS and CCSVI (299 males, 470 females) and 210 controls without ms and ccsvi (92 males, 118 females). each subject was investigated by echo-color-doppler (ecd). morphological and hemodynamic ecd data were recorded by a computerized mem-net maps of epidemiological national observatory on ccsvi and they were analyzed by mem-net clinical analysis programs. RESULTS: VCS of IJVs occurs in 240 subjects affected by CCSVI and MS (31% of total) and in 12 controls (6% of total). The differences between the two groups are statistical significant (X² = 36.64, p<0.0001). CONCLUSION: Up to day there are no longitudinal studies that allow us to identify the WC of jugular and/or vertebral veins as etiology of a chronic neurodegenerative disease, but we note that Venous Compression Syndrome of IJVs is strongly associated with MS and CCSVI. KEY WORDS: Chronic Cerebro-Spinal Venous Insufficiency, Multiple Sclerosis, Venous Compression Syndrome.

Risk of jugular compression blocks in workers exposed to prolonged upright posture.

BACKGROUND: The working posture affects the peripheral venous circulation, although the current literature does not report any correlation between working posture and the abnormalities of the jugular veins flow. The purpose of this preliminary research is to study, in female workers, the prevalence of Venous Compressive Syndrome (VCS) caused by total block of the internal jugular veins flow, so-called "White Compression". Due to complete compression by postural, muscular, fascial, anatomical or bone anomalies, White Compression is not visible by EchoColorDoppler (ECD) and its flow can only be detected by the rotational movements of the head or by Valsalva's maneuver. METHODS: We studied a sample of female workers with ECD (n=128), in supine and upright position divided into subgroups according to the obliged posture maintained during working hours: group A, seated work (n = 61; 47.7%); group B, standing work (n = 41; 32.0%); group C, mixed (both standing and seated work) (n = 26; 20.3%). The total sample (n = 128) had the mean age of 46 ± 10 years (minimum 18 and maximum 67 years) and mean Body Mass Index (BMI) of 23 ± 4 kg/m2 (min 16 kg/m2 and a maximum of 42 kg/m2). RESULTS: Group A and group C did not show any White Compression in orthostatic and clinostatic position. The 9.75% (p = 0.0125) of Group B had a White Compression in orthostatic position: two female workers on the left side (4.9%) and two female workers on the right side (4.9%). CONCLUSIONS: We conclude that there is a risk of jugular compression blocks in female workers exposed to prolonged upright posture. Yet there is no longitudinal study that identifies the White Compressions as etiology of a chronic neurodegenerative disease. The authors hope that some wider studies can confirm the prevalence of these compressions in standing posture and their patho-physiological consequences.

Jugular diameter and venous reflux.

OBJECTIVES: Aims of this study were to investigate the prevalence of reflux on internal jugular veins(IJV) by Valsalva maneuver and to define the association between reflux of IJV in subjects with both CCSVI and MS. METHODS: We recruited 393 patients with MS and CCSVI. Study participants underwent EchoColor Doppler exam in order to define IJV diameter at confluence in subclavian (JSd). Subjects were divided in three groups: group "1

Effect of water and gluten on physico-chemical properties and stability of ready to eat shelf-stable pasta.

A multi-analytical and multi-dimensional approach was used to investigate the effect of moisture and gluten on physico-chemical properties of shelf-stable ready to eat (RTE) pasta. Moisture and frozen water contents were not affected by formulation nor storage time. Hardness and retrograded amylopectin significantly increased during storage in all samples, more markedly in pasta with the lowest moisture content. Higher amounts of water and gluten reduced pasta hardening and contributed to control RTE pasta quality. (1)H FID became steeper in all samples during storage, but no effect of high moisture and gluten levels was observed on the mobility of these protons. Three proton T2 populations were observed (population C, population D and population E). Population C and D were not resolved during all storage. (1)H T2 relaxation time of the most abundant population (population E) shifted to shorter times and the amount of protons increased during storage, more importantly in the samples with lower moisture and gluten content.

New acoustic wave therapy improves quality of life in patients with multiple sclerosis and chronic cerebrospinal venous insufficiency.

A Multiple Sclerosis patient with chronic cerebrospinal venous insufficiency (CCSVI) treated by acoustic waves, modulated in frequency and power of the Dreno-MAM® device, showed a progressive improvement in motor coordination, resistance to work, muscular power and rigidity, and distal microcirculation. Life quality, chronic fatigue, and clinical severity questionnaires EDSS show marked improvements with a follow-up of two years. We suggest that the method could be also used in the chronic fatigue syndrome and other neurological diseases such as Parkinson or Meniere syndrome. Analyses on statistically robust samples are in progress to validate such impressive result obtained by this nonpharmacological and non-invasive treatment.

C1-C2 X-Ray assessment of misalignment parameters in patients with Chronic Cerebra-spinal Venous Insufficiency and Multiple Sclerosis versus patients with other pathologies.

PURPOSE: The complete compression of the internal jugular veins, in front position, shows a prevalence of 48% and it is equally distributed in the various segments of these veins in patients with Chronic Cerebro-Spinal Venous Insufficiency (CCSVI) and Multiple Sclerosis (MS). The aim of this search is to identify radiological dislocation of C1-C2 as specific markers in patients with CCSVI and Multiple Sclerosis (MS). METHOD: We investigated 386 patients suffering from CCSVI and Multiple Sclerosis and a control group of 156 patients without MS. RESULTS: The assessment of Anterior Intrusion shows the following average values: in the group with CCSVI and MS: 4.29 ±1.48 mm while in the control group: 3.78 ±1.45 mm (p = 0.0008).The evaluation of the Right Laterality shows the following average values: in group with CCSVI and MS: 2.31±1.41 mm, in control group: 1.97 ±1.28 mm (p = 0.0426). We found also that a longer duration of the disease corresponds to a higher severity of the pathological condition (p <0.0001). CONCLUSION: Data analysis of C1-C2 X-Ray parameters shows statistical significance of severe anterior intrusion and right laterality misalignment in the people with CCSVI and MS, that are two to three times more frequent as compared to controls. Considering the novelty of this work and the total absence of scientific similar works able to confirm this data, it is necessary to continue these studies in order to improve the clinical management of these patients and to perform therapeutic strategies based on venous decompressive treatments both surgical that manipulatives.

Preliminary results after upper cervical chiropractic care in patients with chronic cerebro-spinal venous insufficiency and multiple sclerosis.

PURPOSE: The aim of the study is to evaluate the clinical and X-ray results of the Upper Cervical Chiropractic care through the specific adjustments (corrections) of C1-C2 on patients with chronic venous cerebral-spinal insufficiency (CCSVI) and multiple sclerosis (MS). METHOD: We studied a sample of 77 patients before and after the Upper Cervical Chiropractic care, and we analyzed: A) The change of the X-ray parameters; B) The clinical results using a new set of questions. The protocol of the C1- C2 upper Cervical Chiropractic treatment, specific for these patients, lasts four months. From a haemodynamic point of view we divided the patients in 3 types: Type 1 - purely vascular with intravenous alterations; Type 2 - "mechanical" with of external venous compressions; Type 3 - mixed. RESULTS: We found an improvement in all kinds of subluxations after the treatment with respect to the pre-treatment X-ray evaluation, with a significant statistical difference. The differences between the clinical symptoms before and after the specific treatment of C1-C2 are statistically significant with p<0.001 according to the CHI-Square test revised by Yates. CONCLUSIONS: The preliminary X-ray and clinical improvements of the Upper Cervical Chiropractic corrections on C1- C2 on these patients with CCSVI and MS encourage us to continue with our studies. We believe that the Upper Cervical correction on C1-C2 could be the main non-invasive treatment of the CCSVI mechanical type in patients with MS. Further studies are required to evaluate the correlation between the Upper Cervical Chiropractic correction on C1-C2 on the cerebral venous drainage and the cerebro-spinal fluid.

Serum adhesion molecules in acute pancreatitis: time course and early assessment of disease severity.

OBJECTIVES: To evaluate the adhesion molecule time course in the early phases of acute pancreatitis and to explore the usefulness of these proteins in assessing the severity of the disease. Fifteen consecutive acute pancreatitis patients (10 patients with the mild and 5 with the severe disease) admitted to the hospital within 6 hours after the onset of pain and 15 age- and sex-matched healthy subjects. METHODS: Vascular cell adhesion molecule 1, intercellular adhesion molecule 1, E-selectin, P-selectin, and L-selectin were quantified on hospital admission and for the following 2 days. RESULTS: Acute pancreatitis patients had vascular cell adhesion molecule 1 and P-selectin concentrations significantly lower and L-selectin concentrations significantly higher than the healthy subjects. Only E-selectin was significantly higher in severe than in mild disease (P = 0.029); a value of E-selectin ranging from 3.83 to 3.92 ng/mL was the best cutoff value for differentiating severe from mild acute pancreatitis (sensitivity: 60.0%, specificity: 90.0%, cases correctly classified: 80%). E-selectin and P-selectin entered the multivariate logistic regression analysis, and a score was calculated showing a sensitivity of 93.3% and a specificity of 86.7% in identifying the patients with severe pancreatitis. CONCLUSIONS: This score seems to be useful for the early assessment of the severity of acute pancreatitis.