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1.
Cardiovasc Diabetol ; 23(1): 146, 2024 Apr 29.
Artículo en Inglés | MEDLINE | ID: mdl-38685051

RESUMEN

BACKGROUND: The GLP-1 receptor agonist liraglutide is used to treat hyperglycemia in type 2 diabetes but is also known to induce weight loss, preserve the beta cell and reduce cardiovascular risk. The mechanisms underlying these effects are however still not completely known. Herein we explore the effect of liraglutide on markers of immune cell activity in a population of obese individuals with prediabetes or newly diagnosed type 2 diabetes mellitus. METHOD: Plasma levels of the monocyte/macrophage markers, soluble (s)CD163 and sCD14, the neutrophil markers myeloperoxidase (MPO) and neutrophil gelatinase-associated lipocalin (NGAL),the T-cell markers sCD25 and T-cell immunoglobulin mucin domain-3 (sTIM-3) and the inflammatory marker TNF superfamily (TNFSF) member 14 (LIGHT/TNFSF14) were measured by enzyme-linked immunosorbent assays in obese individuals with prediabetes or diabetes diagnosed within the last 12 months, prior to and after comparable weight loss achieved with lifestyle changes (n = 20) or liraglutide treatment (n = 20), and in healthy subjects (n = 13). RESULTS: At baseline, plasma levels of the macrophage marker sCD163, and the inflammatory marker LIGHT were higher in cases as compared to controls. Plasma levels of sCD14, NGAL, sTIM-3 and sCD25 did not differ at baseline between patients and controls. After weight reduction following lifestyle intervention or liraglutide treatment, sCD163 decreased significantly in the liraglutide group vs. lifestyle (between-group difference p = 0.023, adjusted for visceral adipose tissue and triglycerides basal values). MPO and LIGHT decreased significantly only in the liraglutide group (between group difference not significant). Plasma levels of MPO and in particular sCD163 correlated with markers of metabolic dysfunction and inflammation. After weight loss, only sCD163 showed a trend for decreased levels during OGTT, both in the whole cohort as in those of liraglutide vs lifestyle group. CONCLUSION: Weight loss following treatment with liraglutide was associated with reduced circulating levels of sCD163 when compared to the same extent of weight loss after lifestyle changes. This might contribute to reduced cardiometabolic risk in individuals receiving treatment with liraglutide.


Asunto(s)
Antígenos CD , Antígenos de Diferenciación Mielomonocítica , Biomarcadores , Diabetes Mellitus Tipo 2 , Incretinas , Liraglutida , Obesidad , Estado Prediabético , Receptores de Superficie Celular , Conducta de Reducción del Riesgo , Pérdida de Peso , Humanos , Liraglutida/uso terapéutico , Liraglutida/efectos adversos , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/terapia , Pérdida de Peso/efectos de los fármacos , Masculino , Persona de Mediana Edad , Femenino , Obesidad/diagnóstico , Obesidad/sangre , Obesidad/terapia , Biomarcadores/sangre , Antígenos de Diferenciación Mielomonocítica/sangre , Estado Prediabético/sangre , Estado Prediabético/diagnóstico , Estado Prediabético/terapia , Estado Prediabético/tratamiento farmacológico , Receptores de Superficie Celular/sangre , Resultado del Tratamiento , Antígenos CD/sangre , Incretinas/uso terapéutico , Incretinas/efectos adversos , Incretinas/sangre , Adulto , Estudios de Casos y Controles , Factores de Tiempo , Regulación hacia Abajo , Hipoglucemiantes/uso terapéutico , Hipoglucemiantes/efectos adversos , Anciano
2.
Int J Mol Sci ; 24(3)2023 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-36768382

RESUMEN

Cholesterol accumulation in macrophages leads to the formation of foam cells and increases the risk of developing atherosclerosis. We have verified whether hydroxytyrosol (HT), a phenolic compound with anti-inflammatory and antioxidant properties, can reduce the cholesterol build up in THP-1 macrophage-derived foam cells. We have also investigated the potential mechanisms. Oil Red O staining and high-performance liquid chromatography (HPLC) assays were utilized to detect cellular lipid accumulation and cholesterol content, respectively, in THP-1 macrophages foam cells treated with HT. The impact of HT on cholesterol metabolism-related molecules (SR-A1, CD36, LOX-1, ABCA1, ABCG1, PPARγ and LRX-α) in foam cells was assessed using real-time PCR (RT-qPCR) and Western blot analyses. Finally, the effect of HT on the adhesion of THP-1 monocytes to human vascular endothelial cells (HUVEC) was analyzed to study endothelial activation. We found that HT activates the PPARγ/LXRα pathway to upregulate ABCA1 expression, reducing cholesterol accumulation in foam cells. Moreover, HT significantly inhibited monocyte adhesion and reduced the levels of adhesion factors (ICAM-1 and VCAM-1) and pro-inflammatory factors (IL-6 and TNF-α) in LPS-induced endothelial cells. Taken together, our findings suggest that HT, with its ability to interfere with the import and export of cholesterol, could represent a new therapeutic strategy for the treatment of atherosclerotic disease.


Asunto(s)
Células Espumosas , PPAR gamma , Humanos , Células Espumosas/metabolismo , PPAR gamma/metabolismo , Células Endoteliales/metabolismo , Colesterol/metabolismo , Inflamación/tratamiento farmacológico , Inflamación/metabolismo , Transportador 1 de Casete de Unión a ATP/genética , Transportador 1 de Casete de Unión a ATP/metabolismo , Receptores X del Hígado/metabolismo
3.
Eat Weight Disord ; 28(1): 30, 2023 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-36947261

RESUMEN

PURPOSE: The aim of this longitudinal study was to examine the extent to which improved levels of binge eating (BE) behaviors, alexithymia, self-esteem, and psychological distress would predict a reduction in body mass at 9-month follow-up, following a lifestyle modification program for weight loss in obese or overweight patients. METHODS: A convenience sample of 120 obese or overweight patients were recruited. Body mass index (BMI), binge eating (BES), levels of alexithymia (TAS-20), perceived stress (PSS), depressive symptoms (SDS), and self-esteem (RSE) were assessed during their first medical examination (T1), and after a weight-loss treatment period of 9 months (T2). RESULTS: Compared with unimproved patients, improved patients reported a significant decrease in binge eating (p = 0.04) and perceived stress symptoms (p = 0.03), and a significant improvement in self-esteem (p = 0.02) over time. After controlling for gender, self-esteem, depressive symptoms, and perceived stress, baseline BMI (OR = 1.11, 95% CI [1.04,1.19]), ΔBES (OR = 0.99, 95% CI [0.98,0.99]), and ΔTAS-20 (OR = 1.03, 95% CI [1.01,1.05]) significantly and independently predicted a ≥ 5% reduction in body mass from baseline. CONCLUSIONS: Our finding supports the suggestion to consider psychological outcomes such as emotional aspects and dysfunctional eating behaviors when planning a weight loss programs to prevent a negative outcome. LEVEL OF EVIDENCE:  Level III, case-control analytic study.


Asunto(s)
Trastorno por Atracón , Bulimia , Humanos , Trastorno por Atracón/terapia , Trastorno por Atracón/psicología , Sobrepeso , Estudios de Seguimiento , Síntomas Afectivos/terapia , Estudios Longitudinales , Obesidad/terapia , Obesidad/psicología , Bulimia/terapia , Pérdida de Peso , Estilo de Vida
4.
Medicina (Kaunas) ; 59(6)2023 Jun 11.
Artículo en Inglés | MEDLINE | ID: mdl-37374327

RESUMEN

Background and Objectives: Obesity is a worldwide disease associated with systemic complications. In recent years, there has been growing interest in studying vitamin D but data related to obese subjects are still poor. AIM: The aim of this study was to evaluate the relationship between obesity degree and 25-hydroxyvitamin D [25(OH)D] levels. Materials and Methods: We recruited 147 Caucasian adult obese patients (BMI > 30 Kg/m2; 49 male; median age 53 years), and 20 overweight subjects as control group (median age 57 years), who had been referred to our Obesity Center of Chieti (Italy) between May 2020 and September 2021. Results: The median BMI was 38 (33-42) kg/m2 for obese patients and 27 (26-28) kg/m2 for overweight patients. 25(OH)D concentrations were lower in the obese population compared to the overweight population (19 ng/mL vs. 36 ng/mL; p < 0.001). Considering all obese subjects, a negative correlation was observed between 25(OH)D concentrations and obesity-related parameters (weight, BMI, waist circumference, fat mass, visceral fat, total cholesterol, LDL cholesterol) and glucose metabolism-related parameters. 25(OH)D was also negatively correlated with blood pressure. Conclusions: Our data confirmed the inverse relationship between obesity and blood concentration of 25(OH)D and highlighted how 25(OH)D levels decrease in the presence of glucose and lipid metabolism alterations.


Asunto(s)
Sobrepeso , Deficiencia de Vitamina D , Adulto , Humanos , Masculino , Persona de Mediana Edad , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Deficiencia de Vitamina D/complicaciones , Índice de Masa Corporal , Obesidad/complicaciones , Vitamina D , Calcifediol
5.
Eat Weight Disord ; 26(6): 1813-1823, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32920774

RESUMEN

PURPOSE: Alexithymia, a personality trait characterized by difficulties in emotional processing, has been associated with unhealthy behaviors and chronic medical conditions. This study aimed to further develop our understanding of this complex relationship by investigating whether alexithymia increases the risk of metabolic syndrome (MetS) in participants with obesity or overweight through the mediating role of binge eating (BE). METHODS: A consecutive sample of 238 treatment-seeking patients with obesity or overweight were recruited. Alexithymia (TAS-20), binge eating symptoms (BES), body mass index (BMI), and depression and anxiety symptoms (HADS) were concurrently assessed. RESULTS: Almost half of the participants met the criteria for MetS (44.12%). Compared to patients without MetS, those with MetS were older, had a longer duration of overweight, and had a higher BMI (p < 0.01). Individual with MetS also had higher HADS, BES, and TAS-20 scores, particularly difficulty identifying and describing feelings. The structural equation modeling (SEM) analysis revealed that BES levels exerted a significant direct effect on MetS (p < 0.01), and that TAS-20 levels exerted a significant direct effect on BES (p < 0.01), anxiety (p < 0.001) and depression (p < 0.001). Moreover, psychological distress (anxiety, p = 0.01, and depression, p = .05) indirectly affected MetS through the mediating effect of BES, and TAS-20 (p = 0.01) indirectly affected MetS through the mediating effect of HADS and BES. Finally, age had a significant direct effect on MetS (p < 0.001). CONCLUSION: Our findings indicate that alexithymia is a concurrent causative factor to the development of MetS through the mediating role of BE and psychological distress. LEVEL OF EVIDENCE: Level III, case-control analytic study.


Asunto(s)
Trastorno por Atracón , Bulimia , Síndrome Metabólico , Síntomas Afectivos/complicaciones , Trastorno por Atracón/complicaciones , Índice de Masa Corporal , Bulimia/complicaciones , Humanos , Síndrome Metabólico/complicaciones
6.
Eat Weight Disord ; 26(6): 1801-1811, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32920775

RESUMEN

PURPOSE: It is well known that body mass index (BMI) affects how individuals perceive their well-being and that obese individuals tend to report poorer levels of subjective health status. The aim of this study was to compare subjects with and without FSD and to examine the direct and indirect impact of BMI on female sexual dysfunction (FSD) in overweight/obese and normal-weight women. METHODS: A cross-sectional study was conducted on 186 overweight/obese and 233 normal-weight women. FSD assessed with the Female Sexual Function Index (FSFI) was investigated in relation to body satisfaction assessed with the Body Uneasiness Test (BUT-A) and self-esteem assessed with the Rosenberg Self-Esteem scale (RSE). RESULTS: No difference in the prevalence of FSD was found between overweight/obese (44.4%) and normal-weight women (55.6%), even though significant between-group differences in body image were found. Structural Equation Modelling (SEM) showed that BMI contribute to FSD only through the mediating role of body dissatisfaction and self-esteem. CONCLUSIONS: The present results support the notion that sexual functioning is not related directly to BMI in women but to a more complex interactions of body weight, satisfaction with one's own body image, and levels of self-esteem. Clinicians should take into account that for women having a good sexual life seems not related to body weight but to the way their body weight is perceived within the context of self-image. LEVEL OF EVIDENCE: Level III, case-control analytic study.


Asunto(s)
Imagen Corporal , Sobrepeso , Índice de Masa Corporal , Peso Corporal , Estudios Transversales , Femenino , Humanos , Obesidad , Autoimagen
7.
Int J Mol Sci ; 21(8)2020 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-32344526

RESUMEN

The renin-angiotensin system (RAS) plays a main role in regulating blood pressure and electrolyte and liquid balance. Previous evidence suggests that RAS may represent an important target for the treatment of lung pathologies, especially for acute respiratory distress syndrome and chronic fibrotic disease. The scientific community has recently focused its attention on angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor 1 (AT1R) inhibitors and their possible benefit/harms for patients infected by Coronavirus disease (COVID-19) who experience pneumonia, but there are still some doubts about the effects of these drugs in this setting.


Asunto(s)
Betacoronavirus/fisiología , Sistema Renina-Angiotensina , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , COVID-19 , Infecciones por Coronavirus/virología , Humanos , Hipertensión/tratamiento farmacológico , Pandemias , Neumonía Viral/virología , Sistema Renina-Angiotensina/efectos de los fármacos , Síndrome de Dificultad Respiratoria , SARS-CoV-2
8.
Int J Mol Sci ; 21(7)2020 Apr 04.
Artículo en Inglés | MEDLINE | ID: mdl-32260425

RESUMEN

Extracellular vesicles act as shuttle vectors or signal transducers that can deliver specific biological information and have progressively emerged as key regulators of organized communities of cells within multicellular organisms in health and disease. Here, we survey the evolutionary origin, general characteristics, and biological significance of extracellular vesicles as mediators of intercellular signaling, discuss the various subtypes of extracellular vesicles thus far described and the principal methodological approaches to their study, and review the role of extracellular vesicles in tumorigenesis, immunity, non-synaptic neural communication, vascular-neural communication through the blood-brain barrier, renal pathophysiology, and embryo-fetal/maternal communication through the placenta.


Asunto(s)
Biomarcadores/metabolismo , Enfermedad/genética , Vesículas Extracelulares/metabolismo , Comunicación Celular , Vesículas Extracelulares/genética , Predisposición Genética a la Enfermedad , Humanos , Inmunidad , Transducción de Señal
9.
Int J Mol Sci ; 21(21)2020 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-33114229

RESUMEN

Extracellular vesicles (EVs) play a crucial role in the intercellular crosstalk. Mesenchymal stem cell-derived EVs (MSC-EVs), displaying promising therapeutic roles, contribute to the strong rationale for developing EVs as an alternative therapeutic option. EV analysis still represents one of the major issues to be solved in order to translate the use of MSC-EV detection in clinical settings. Even if flow cytometry (FC) has been largely applied for EV studies, the lack of consensus on protocols for FC detection of EVs generated controversy. Standard FC procedures, based on scatter measurements, only allows the detection of the "tip of the iceberg" of all EVs. We applied an alternative FC approach based on the use of a trigger threshold on a fluorescence channel. The EV numbers obtained by the application of the fluorescence triggering resulted significantly higher in respect to them obtained from the same samples acquired by placing the threshold on the side scatter (SSC) channel. The analysis of EV concentrations carried out by three different standardized flow cytometers allowed us to achieve a high level of reproducibility (CV < 20%). By applying the here-reported method highly reproducible results in terms of EV analysis and concentration measurements were obtained.


Asunto(s)
Vesículas Extracelulares/metabolismo , Citometría de Flujo/métodos , Células Madre Mesenquimatosas/citología , Animales , Células Cultivadas , Dispersión Dinámica de Luz , Separación Inmunomagnética , Células Madre Mesenquimatosas/metabolismo
10.
Adv Exp Med Biol ; 1211: 61-68, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31309516

RESUMEN

Long-term exposure to high altitude causes adaptive changes in several blood biochemical markers along with a marked body mass reduction involving both the lean and fat components. The aim of this study was to evaluate the impact of extended physical strain, due to extensive trekking at high altitude, on body composition, selected biomarkers in the blood, and the protective role of a high-protein diet in muscle dysfunction. We found that physical strain at high altitude caused a significant reduction in body mass and body fat, with a concomitant increase in the cross-sectional area of thigh muscles and an unchanged total lean body mass. Further, we found reductions in plasma leptin and homocysteine, while myoglobin, insulin, and C-reactive protein significantly increased. Creatine kinase, lactate dehydrogenase, and leptin normalized per body fat were unchanged. These findings demonstrate that high-altitude hypoxia, involving extended physical effort, has an impact on muscle function and body composition, facilitating sarcopenia and affecting body mass and fat distribution. It also activates pro-inflammatory metabolic pathways in response to muscular distress. These changes can be mitigated by a provision of a high-protein diet.


Asunto(s)
Adaptación Fisiológica , Altitud , Composición Corporal , Sistema Endocrino/fisiología , Biomarcadores/sangre , Dieta Rica en Proteínas , Humanos , Hipoxia , Sarcopenia
11.
Eur Eat Disord Rev ; 27(6): 628-640, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31264316

RESUMEN

OBJECTIVE: To investigate whether obese patients with binge eating (BE) have higher alexithymic features; to explore the different relationships between psychological features (alexithymia, depression, and anxiety) and BE. METHOD: Three hundred sixty one obese BE-patients were evaluated for alexithymia, psychological distress, and BE. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20); BE was assessed with the BE Scale (BES), and depression and anxiety symptoms were evaluated with the Hospital Anxiety and Depression Scale (HADS). RESULTS: Patients with BE reported significantly higher TAS-20 total scores than those without BE (p < .001). The SEM analysis showed that the difficulty in identifying feelings (DIF) and difficulty in describing feelings (DDF) components of alexithymia affected BE along different pathways. DIF was found as a major factor influencing altered eating both directly (p = .20*) and above all through the mediation of psychological distress (p = .19***), whereas DDF affected BE only through psychological distress at a lesser extent (p = .09**). DISCUSSION: Alexithymic difficulties in affective awareness may play an important role in the onset and maintenance of BE, especially when patients experienced anxiety and depression symptoms. Clinicians involved in the management of obesity should address the combination of alexithymic traits and emotional distress by planning effective client-focused interventions.


Asunto(s)
Síntomas Afectivos/epidemiología , Bulimia/epidemiología , Obesidad/terapia , Pacientes Ambulatorios/psicología , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Pacientes Ambulatorios/estadística & datos numéricos , Programas de Reducción de Peso , Adulto Joven
12.
Circ J ; 80(2): 502-11, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26632534

RESUMEN

BACKGROUND: Circulating pentraxin 3 (PTX3), the main regulator of the inflammatory response, rapidly increases following cardiovascular events, and low PTX3 is associated with high body mass index. METHODS AND RESULTS: We conducted a 12-month longitudinal study, to test the hypothesis that laparoscopic adjustable gastric banding (LAGB)-induced weight loss was associated with changes in platelet activation markers and PTX3. Twelve obese patients, scheduled to undergo LAGB, were enrolled at the University Obesity Center. Urinary 11-dehydro-thromboxane (Tx)B2excretion rate was measured on radioimmunoassay, and PTX3 and CD40L were determined on immunoassay. Plasma PTX3 increased by 178.8 and 214.9% (P<0.0001), respectively, 6 and 12 months after LAGB. High-sensitivity CRP decreased by 24 and 29.7% (P<0.0001), whereas CD40L decreased by 64.3 and 58.6% (P=0.002), respectively. Urinary 11-dehydro-TxB2decreased from 1,443 to 715 and 564 pg/mg creatinine, respectively 6 months and 12 months after LAGB (P<0.0001). PTX3 was inversely related to platelet activation markers, 11-dehydro-TxB2and CD40L. Moreover, multiple regression analysis on pooled data showed that plasma PTX3 was an independent predictor of urinary 11-dehydro-TxB2. CONCLUSIONS: There is an association between inflammation, platelet activation and metabolic dysfunction in obesity, and PTX3 is a key player within these circuits.


Asunto(s)
Proteína C-Reactiva/metabolismo , Derivación Gástrica , Obesidad/sangre , Obesidad/cirugía , Activación Plaquetaria , Componente Amiloide P Sérico/metabolismo , Adulto , Ligando de CD40/sangre , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Obesidad/orina , Tromboxano B2/análogos & derivados , Tromboxano B2/orina
13.
J Clin Med ; 13(8)2024 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-38673575

RESUMEN

Background: The application of transthoracic contrast-enhanced ultrasound (CEUS) to the study of peripheral lung lesions is still a topic of debate. The main objective of this review was to evaluate the diagnostic accuracy of CEUS in the diagnosis of malignant subpleural pulmonary consolidations and, therefore, differentiate them from benign ones. Methods: Papers published before December 2023 were detected through a search of PubMed, Cochrane library, and Embase. The pooled specificity and sensitivity, summary receiver operating characteristic (SROC) curve and diagnostic odds ratio (DOR) were used. Results: CEUS is characterized by a pooled sensitivity of 0.95 (95% CI: 0.93-0.97) and a pooled specificity of 0.93 (95% CI: 0.90-0.95) in differentiating benign and malignant subpleural lung diseases; the AUC of SROC was 0.97. Homogeneous CE was characterized by a pooled sensitivity of 0.43 (95% CI: 0.40-0.45) and the pooled specificity of 0.49 (95% CI: 0.46-0.52). Non-homogeneous CE displayed a pooled sensitivity of 0.57 (95% CI: 0.55-0.60) and a pooled specificity of 0.51 (95% CI: 0.48-0.54). The lack of CE displayed a pooled sensitivity of 0.01 (95% CI: 0.00-0.06) and a pooled specificity of 0.76 (95% CI: 0.64-0.85). Marked CE displayed a pooled sensitivity of 0.41 (95% CI: 0.37-0.44) and a pooled specificity of 0.54 (95% CI: 0.50-0.58). Non-marked CE displayed a pooled sensitivity of 0.59 (95% CI: 0.56-0.63) and a pooled specificity of 0.46 (95% CI: 0.42-0.50). The early AT displayed a pooled sensitivity of 0.04 (95% CI: 0.02-0.08) and a pooled specificity of 0.83 (95% CI: 0.77-0.87). The early wash out displayed a pooled sensitivity of 0.61 (95% CI: 0.48-0.72) and a pooled specificity of 0.98 (95% CI: 0.92-1.00). The delayed wash out displayed a pooled sensitivity of 0.15 (95% CI: 0.10-0.20) and a pooled specificity of 0.69 (95% CI: 0.62-0.75). Conclusions: CEUS is characterized by excellent diagnostic accuracy for the diagnosis of the malignancy of subpleural lung lesions. By separately analyzing the CEUS findings, the diagnostic accuracy values are considerably lower and not significant in some cases. The simultaneous evaluation of multiple CEUS features allows us to reach an excellent diagnostic accuracy. Non-homogeneous CE with early wash out are the most indicative features of malignancy of a lung lesion.

14.
Radiol Case Rep ; 18(3): 1024-1028, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36684629

RESUMEN

Benign focal liver lesions are among the most frequent findings on ultrasound. Liver hemangiomas are often easily recognizable on ultrasound examination and are characterized by a clear benign prognosis. In some cases, hemangiomas display an atypical appearance both on B-mode and on contrast-enhanced ultrasound, thus raising concerns for differential diagnosis both with adenomas and with lesions of malignant nature. We report here the case of a patient who presented with a liver lesion with all signs suggestive for hemangioma on B-mode, but it showed atypical features on contrast-enhanced ultrasound examination and final diagnosis of liver adenoma.

15.
J Ultrasound ; 2023 Oct 05.
Artículo en Inglés | MEDLINE | ID: mdl-37798426

RESUMEN

PURPOSE: Ultrasound is essential in the clinical practice of many medical specialties due to non-invasiveness, rapidity of examination, low costs and simplicity. Many specialized companies and universities pointed out its potential as a teaching tool for medical students. The aim of our study is to evaluate the impact of an ultrasound course on a sample of students attending the fourth, fifth and sixth year of the degree course in Medicine, highlighting changing in satisfaction and preparation. Another target is to verify the capability of a course on ultrasound to positively impact on participants knowledge and competences. METHODS: Students attending 6 training courses of Medicine held between 2017 and 2019 were recruited. Five trainings held during an Italian society of ultrasound in medicine and biology (SIUMB) congress, in a session dedicated to students, and one during an elective didactic activity (ADE) held in Chieti University. A questionnaire was given to the students before and after the course, in order to assess the impact of the course on the motivation and knowledge. Moreover, a test was also administered at the end of the theoretical part, with questions relating to the notions learned. RESULTS: There was an 81% of correct response to the learning questionnaire by calculating the mean of 5 SIUMB courses performed. The students are strongly motivated to continue learning ultrasound already from the beginning of the course, and this result remains unchanged in the questionnaire administered at the end. The interest of students towards this method is high, and they would ultrasound courses within the Medicine degree, even before participating in the training. It was evident how students positively assessed the course in relation to the acquisition of skills and knowledge, albeit with a tendency to acquire more knowledge rather than skills. CONCLUSIONS: Our data support the usefulness of including ultrasound into the curriculum of medical students and on its use as a teaching tool. Students are highly motivated and perceive a significant improvement in both skills and knowledge following the proposed courses. Hands-on part is necessary in the training course on ultrasonography.

16.
J Clin Med ; 12(3)2023 Jan 19.
Artículo en Inglés | MEDLINE | ID: mdl-36769448

RESUMEN

Acute bowel diseases are responsible for more than one third of subjects who were referred to the emergency department for acute abdominal pain and gastrointestinal evaluation. Gastrointestinal ultrasound (GIUS) is often employed as the first imaging method, with a good diagnostic accuracy in the setting of acute abdomen, and it can be an optimal diagnostic strategy in young females due to the radiation exposure related to X-ray and computed tomography methods. The physician can examine the gastrointestinal system in the area with the greatest tenderness by ultrasound, thus obtaining more information and data on the pathology than the standard physical examination. In this comprehensive review, we have reported the most relevant indications and advantages to using ultrasound in the investigation of abdominal acute pain.

17.
Biomedicines ; 11(3)2023 Mar 13.
Artículo en Inglés | MEDLINE | ID: mdl-36979861

RESUMEN

Non-alcoholic fatty liver disease (NAFLD) is defined as a chronic liver disease characterized by excessive fat accumulation in the liver without another obvious cause (no excessive alcohol consumption, hepatotoxic medications, toxins, viral infections, genetic hepatic diseases), therefore it is an exclusion diagnosis. The term NAFLD literally refers to non-alcohol related hepatopathy and does not adequately correlate with metabolic dysfunction and related cardiovascular risks. Therefore, researchers and scientific societies have moved towards changing the terminology. The novel nomenclature for a metabolic-associated fatty liver disease (MAFLD) has been proposed in 2020 by a group of experts to overcome the issues related to the old terminology. The diagnosis of MAFLD is based on the presence of hepatic steatosis and at least one between these three conditions: type 2 diabetes mellitus (T2DM), obesity or metabolic dysregulation. MAFLD has been shown to be an independent risk factor for cardiovascular diseases and atherosclerosis. It is better related to the main risk factors for atherosclerosis and cardiovascular diseases than NAFLD, such as dyslipidemia, T2DM and hypertension. The aim of this review is to highlight the reasons why the term NAFLD is moving to the term MAFLD, what are the conceptual basis of this choice and its clinical implications, particularly in the cardiovascular field.

18.
Artículo en Inglés | MEDLINE | ID: mdl-37047909

RESUMEN

BACKGROUND: The surgical dental treatment of subjects admitted for anticoagulants therapy represents a consistent risk for peri-operative bleeding. The aim of the present study was to investigate the clinical findings of dental surgery operative management of the patients under anticoagulants drugs protocol. METHODS: The literature screening was performed using Pubmed/Medline, EMBASE and Cochrane library, considering only randomized clinical trials (RCTs) papers. No limitations about the publication's period, follow-up time or clinical parameters were considered. RESULTS: A total of eight RCTs were included for the qualitative synthesis. No thromboembolic complications were reported in any studies. Several bleeding episodes associated with anticoagulant drugs in dental surgery were mild and generally happened on the first day after the treatment. CONCLUSIONS: The use of local haemostatic measures is generally effective for bleeding control with no further pharmacological drug management or suspension.


Asunto(s)
Fibrinolíticos , Tromboembolia , Humanos , Fibrinolíticos/uso terapéutico , Metaanálisis en Red , Hemorragia , Anticoagulantes
19.
J Clin Med ; 12(4)2023 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-36835938

RESUMEN

The application of thoracic ultrasound examination has not long been developed because ultrasound's interaction with the lung does not generate an anatomical image but an artifactual one. Subsequently, the evaluation of pulmonary artifacts and their correlation to specific diseases allowed the development of ultrasound semantics. Currently, pneumonia still represents one of the main causes of hospitalization and mortality. Several studies in the literature have demonstrated the ultrasound features of pneumonia. Although ultrasound cannot be considered the diagnostic gold standard for the study of all lung diseases, it has experienced an extraordinary development and growth of interest due to the SARS-CoV-2 pandemic. This review aims to provide essential information on the application of lung ultrasound to the study of infectious pneumonia and to discuss the differential diagnosis.

20.
J Psychosom Res ; 164: 111102, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36508846

RESUMEN

OBJECTIVE: Long-term changes in burnout and its predictors in hospital staff during the COVID-19 pandemic were investigated in an international study. METHODS: Two online surveys were distributed to hospital staff in seven countries (Germany, Andorra, Ireland, Spain, Italy, Romania, Iran) between May and October 2020 (T1) and between February and April 2021 (T2), using the following variables: Burnout (emotional exhaustion and depersonalization), job function, age, gender, and contact with COVID-19 patients; individual resources (self-compassion, sense of coherence, social support) and work-related resources and demands (support at the workplace, risk perception, health and safety at the workplace, altruistic acceptance of risk). Data were analyzed using linear mixed models repeated measures, controlled for age. RESULTS: A total of 612 respondents were included (76% women). We found an increase in burnout from T1 to T2. Burnout was high among personnel with high contact with COVID-19 patients. Individual factors (self-compassion, sense of coherence) and work-related factors (support at the workplace, risk perception, health and safety at the workplace) showed associations with burnout. Low health and safety at the workplace at T1 was associated with an increase in emotional exhaustion at T2. Men showed an increase in depersonalization if they had much contact with COVID-19 patients. CONCLUSION: Burnout represents a potential problematic consequence of occupational contact with COVID-19 patients. Special attention should be paid to this group in organizational health management. Self-compassion, sense of coherence, support at the workplace, risk perception, and health and safety at the workplace may be important starting points for interventions. REGISTRATION: Müller, M. M. (2020, August 30). Cope-Corona: Identifying and strengthening personal resources of hospital staff to cope with the Corona pandemic. Open Science Foundation.


Asunto(s)
Agotamiento Profesional , COVID-19 , Masculino , Humanos , Femenino , Pandemias , COVID-19/epidemiología , Agotamiento Profesional/epidemiología , Agotamiento Profesional/psicología , Personal de Hospital , Encuestas y Cuestionarios , Estudios Longitudinales , Satisfacción en el Trabajo
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