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1.
Ann Ig ; 35(3): 359-366, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36896954

RESUMO

Abstract: The prevalence of obesity and of other non-communicable diseases related to overnutrition is significantly increasing in the past few years. Policy makers are called to counteract this pandemic, orienting consumers towards a healthier and more sustainable diet. Most of the proposed initiatives are dedicated to the content of nutrients with "unfavourable" effects but, in fact, focusing the attention only or mainly on single foods or nutrients is not effective in decreasing the incidence/prevalence of non-communicable diseases. Whole dietary patterns play by far a more important role than specific dietary components in promoting health and modulating survival; and the adherence to eating patterns like the Mediterranean diet reduces the risk of non-communicable diseases. The challenge is therefore to be able to transmit information relating to a healthy eating pattern through positive messages in a few simple indications which in turn represent the nutritional, but also the socio-cultural, environmental and economic characteristics of a healthy and sustainable dietary model. The Mediterranean Diet is normally proposed through a graphic depiction that represents a pyramid which is a simple and effective representation but not of immediate impact. For this reason, we are proposing to adopt the "Sapienza Count-down for a Healthy and Sustainable Diet" that will integrate the pyramid with a more immediate approach.


Assuntos
Dieta Mediterrânea , Doenças não Transmissíveis , Humanos , Dieta , Dieta Saudável , Comportamento Alimentar , Obesidade
2.
Neurol Sci ; 41(5): 1075-1079, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31863327

RESUMO

INTRODUCTION: Multiple sclerosis (MS) refers to chronic inflammation of the central nervous system including the brain and spinal cord. Dysphagia is a symptom that represents challenges in clinical practice. The aim of the present study was to evaluate the prevalence of dysphagia in an Italian cohort of subjects with MS using the Dysphagia Outcome Severity Score (DOSS), based on fibre-optic endoscopy, and determine factors that correlate with the presence of swallowing problems. MATHERIALS AND METHODS: Data were collected in a multicentre study from a consecutive sample of MS patients, irrespective of self-reported dysphagia. The study included 215 subjects. Possible scores for DOSS range from 7 to 1, with 7 indicating normal swallowing. RESULTS: One hundred twenty-four (57.7%) subjects demonstrated abnormal swallowing and 57 (26.5%) of these had swallowing problems that required nutrition/diet modifications when evaluated objectively with fibre-optic endoscopy. Subjects with dysphagia were more severely disabled and more often had a progressive form of MS, compared to MS subjects with normal swallowing. In subjects with EDSS, < 4, 8 (13.3%), had a DOSS < 4. Seventy-five percent of subjects older than 60 years of age had dysphagia. CONCLUSION: In this sample of MS patients, more nearly 60% showed swallowing problems.


Assuntos
Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/epidemiologia , Esclerose Múltipla/epidemiologia , Estudos de Coortes , Transtornos de Deglutição/complicações , Endoscopia/métodos , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Fibras Ópticas , Prevalência , Índice de Gravidade de Doença
3.
Osteoporos Int ; 30(2): 391-402, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30178159

RESUMO

An innovative, non-ionizing technique to diagnose osteoporosis on lumbar spine and femoral neck was evaluated through a multicenter study involving 1914 women. The proposed method showed significant agreement with reference gold standard method and, therefore, a potential for early osteoporosis diagnoses and possibly improved patient management. INTRODUCTION: To assess precision (i.e., short term intra-operator precision) and diagnostic accuracy of an innovative non-ionizing technique, REMS (Radiofrequency Echographic Multi Spectrometry), in comparison with the clinical gold standard reference DXA (dual X-ray absorptiometry), through an observational multicenter clinical study. METHODS: In a multicenter cross-sectional observational study, a total of 1914 postmenopausal women (51-70 years) underwent spinal (n = 1553) and/or femoral (n = 1637) DXA, according to their medical prescription, and echographic scan of the same anatomical sites performed with the REMS approach. All the medical reports (DXA and REMS) were carefully checked to identify possible errors that could have caused inaccurate measurements: erroneous REMS reports were excluded, whereas erroneous DXA reports were re-analyzed where possible and otherwise excluded before assessing REMS accuracy. REMS precision was independently assessed. RESULTS: In the spinal group, quality assessment on medical reports produced the exclusion of 280 patients because of REMS errors and 78 patients because of DXA errors, whereas 296 DXA reports were re-analyzed and corrected. Analogously, in the femoral group there were 205 exclusions for REMS errors, 59 exclusions for DXA errors, and 217 re-analyzed DXA reports. In the resulting dataset (n = 1195 for spine, n = 1373 for femur) REMS outcome showed a good agreement with DXA: the average difference in bone mineral density (BMD, bias ± 2SD) was -0.004 ± 0.088 g/cm2 for spine and - 0.006 ± 0.076 g/cm2 for femur. Linear regression showed also that the two methods were well correlated: standard error of the estimate (SEE) was 5.3% for spine and 5.8% for femur. REMS precision, expressed as RMS-CV, was 0.38% for spine and 0.32% for femur. CONCLUSIONS: The REMS approach can be used for non-ionizing osteoporosis diagnosis directly on lumbar spine and femoral neck with a good level of accuracy and precision. However, a more rigorous operator training is needed to limit the erroneous acquisitions and to ensure the full clinical practicability.


Assuntos
Colo do Fêmur/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Osteoporose Pós-Menopausa/diagnóstico por imagem , Absorciometria de Fóton/métodos , Idoso , Densidade Óssea/fisiologia , Estudos Transversais , Feminino , Colo do Fêmur/fisiopatologia , Humanos , Vértebras Lombares/fisiopatologia , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/fisiopatologia , Reprodutibilidade dos Testes , Ultrassonografia/métodos
4.
Reumatismo ; 68(1): 1-39, 2016 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-27339372

RESUMO

Osteoporosis poses a significant public health issue. National Societies have developed Guidelines for the diagnosis and treatment of this disorder with an effort of adapting specific tools for risk assessment on the peculiar characteristics of a given population. The Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS) has recently revised the previously published Guidelines on the diagnosis, riskassessment, prevention and management of primary and secondary osteoporosis. The guidelines were first drafted by a working group and then approved by the board of SIOMMMS. Subsequently they received also the endorsement of other major Scientific Societies that deal with bone metabolic disease. These recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on leading experts' experience and opinion, and on good clinical practice. The osteoporosis prevention should be based on the elimination of specific risk factors. The use of drugs registered for the treatment of osteoporosis are recommended when the benefits overcome the risk, and this is the case only when the risk of fracture is rather high as measured with variables susceptible to pharmacological effect. DeFRA (FRAX® derived fracture risk assessment) is recognized as a useful tool for easily estimate the long-term fracture risk. Several secondary forms of osteoporosis require a specific diagnostic and therapeutic management.


Assuntos
Absorciometria de Fóton , Densidade Óssea , Osteoporose , Reumatologia , Absorciometria de Fóton/métodos , Medicina Baseada em Evidências , Humanos , Incidência , Itália/epidemiologia , Metanálise como Assunto , Osteoporose/diagnóstico , Osteoporose/epidemiologia , Osteoporose/prevenção & controle , Osteoporose/terapia , Fraturas por Osteoporose/prevenção & controle , Medição de Risco , Fatores de Risco , Sociedades Médicas
5.
Reumatismo ; 66(2): 136-43, 2014 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-25069495

RESUMO

As a result of population ageing worldwide, osteoporotic fractures are becoming a serious problem in the western world. Osteoporotic fractures are associated with a significant burden in terms of morbidity, mortality, and economic costs. Although less frequent than in women, male osteoporosis is also a relatively common problem. Since bone loss and fragility fractures in men have been recognized as a serious medical condition, over the last two decades several studies have investigated a number of aspects related to the pathogenesis, diagnosis and assessment, prevention and treatment of male osteoporosis. A better understanding of factors underlying increased bone fragility in men has led to the definition of appropriate screening and diagnostic strategies, and the development of treatments that have shown to improve bone mineral density and, in some cases, reduce fracture risk in men as well as in women. This review will summarize recent findings on male osteoporosis with a particular focus on risk factors and causes of bone loss, and available therapeutic options.


Assuntos
Osteoporose , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Osteoporose/complicações , Osteoporose/diagnóstico , Osteoporose/epidemiologia , Osteoporose/terapia , Fraturas por Osteoporose/etiologia , Fatores Sexuais
6.
Hum Reprod ; 28(5): 1210-20, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23462389

RESUMO

STUDY QUESTION: Is it feasible to identify factors that significantly affect the clinical outcome of IVF-ICSI cycles and use them to reliably design a predictor of implantation? SUMMARY ANSWER: The Bayesian network (BN) identified top-history embryos, female age and the insemination technique as the most relevant factors for predicting the occurrence of pregnancy (AUC, area under curve, of 0.72). In addition, it could discriminate between no implantation and single or twin implantations in a prognostic model that can be used prospectively. WHAT IS KNOWN ALREADY: The key requirement for achieving a single live birth in an IVF-ICSI cycle is the capacity to estimate embryo viability in relation to maternal receptivity. Nevertheless, the lack of a strong predictor imposes several restrictions on this strategy. STUDY DESIGN, SIZE, DURATION: Medical histories, laboratory data and clinical outcomes of all fresh transfer cycles performed at the International Institute for Reproductive Medicine of Lugano, Switzerland, in the period 2006-2008 (n = 388 cycles), were retrospectively evaluated and analyzed. PARTICIPANTS/MATERIALS, SETTING, METHODS: Patients were unselected for age, sperm parameters or other infertility criteria. Before being admitted to treatment, uterine anomalies were excluded by diagnostic hysteroscopy. To evaluate the factors possibly related to embryo viability and maternal receptivity, the class variable was categorized as pregnancy versus no pregnancy and the features included: female age, number of previous cycles, insemination technique, sperm of proven fertility, the number of transferred top-history embryos, the number of transferred top-quality embryos, the number of follicles >14 mm and the level of estradiol on the day of HCG administration. To assess the classifier, the indicators of performance were computed by cross-validation. Two statistical models were used: the decision tree and the BN. MAIN RESULTS AND THE ROLE OF CHOICE: The decision tree identified the number of transferred top-history embryos, female age and the insemination technique as the features discriminating between pregnancy and no pregnancy. The model achieved an accuracy of 81.5% that was significantly higher in comparison with the trivial classifier, but the increase was so modest that the model was clinically useless for predictions of pregnancy. The BN could more reliably predict the occurrence of pregnancy with an AUC of 0.72, and confirmed the importance of top-history embryos, female age and insemination technique in determining implantation. In addition, it could discriminate between no implantation, single implantation and twin implantation with the AUC of 0.72, 0.64 and 0.83, respectively. LIMITATIONS, REASONS FOR CAUTION: The relatively small sample of the study did not permit the inclusion of more features that could also have a role in determining the clinical outcome. The design of this study was retrospective to identify the relevant features; a prospective study is now needed to verify the validity of the model. WIDER IMPLICATIONS OF THE FINDINGS: The resulting predictive model can discriminate with reasonable reliability between pregnancy and no pregnancy, and can also predict the occurrence of a single pregnancy or multiple pregnancy. This could represent an effective support for deciding how many embryos and which embryos to transfer for each couple. Due to its flexibility, the number of variables in the predictor can easily be increased to include other features that may affect implantation. STUDY FUNDING/COMPETING INTERESTS: This study was supported by a grant, CTI Medtech Project Number: 9707.1 PFLS-L, Swiss Confederation. No competing interests are declared.


Assuntos
Técnicas de Apoio para a Decisão , Transferência Embrionária/métodos , Fertilização in vitro/métodos , Injeções de Esperma Intracitoplásmicas/métodos , Algoritmos , Área Sob a Curva , Teorema de Bayes , Implantação do Embrião , Feminino , Humanos , Masculino , Idade Materna , Oócitos/citologia , Gravidez , Resultado da Gravidez , Probabilidade , Prognóstico , Reprodutibilidade dos Testes , Espermatozoides/metabolismo
7.
Reumatismo ; 65(4): 143-66, 2013 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-24192561

RESUMO

The range of osteoporosis treatments is increasingly large and, like any disease, the pharmacological management of patients should involve a risk/benefit evaluation to attain the greatest reduction in risk of fracture with the lowest incidence of adverse events. The aim of this review is to critically appraise the literature about the safety issues of the main pharmacological treatments of osteoporosis. This document is the result of a consensus of experts based on a systematic review of regulatory documents, randomized controlled trials, metaanalyses, pharmacovigilance surveys and case series related to possible adverse drug reactions to osteoporosis treatment with calcium and vitamin D supplements, bisphosphonates, strontium ranelate, selective estrogen receptor modulators, denosumab, and teriparatide. As expected, randomized controlled trials showed only the most common adverse events due to the samples size and the short observation time. Case series and observational studies are able to provide data about uncommon side effects, but in some cases a sure cause-effect relationship needs still to be confirmed. Consistently with methodological limitations, the newer drugs have a tolerance profile that has not been fully explored yet. Osteoporosis treatments showed an overall good tolerance profile with rare serious adverse events that, however, must be well known by the clinician who prescribes these drugs. The concern about possible adverse events should be weighed against the reduction of morbidity and mortality associated with a significant fracture risk reduction.


Assuntos
Osteoporose/tratamento farmacológico , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/uso terapêutico , Cálcio/efeitos adversos , Cálcio/uso terapêutico , Denosumab , Difosfonatos/efeitos adversos , Difosfonatos/uso terapêutico , Moduladores de Receptor Estrogênico/efeitos adversos , Moduladores de Receptor Estrogênico/uso terapêutico , Humanos , Tiofenos/efeitos adversos , Tiofenos/uso terapêutico , Vitamina D/efeitos adversos , Vitamina D/uso terapêutico
8.
Toxicol In Vitro ; 89: 105576, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36809832

RESUMO

The purpose of this study was to develop a defined approach (DA) for eye hazard identification according to the three UN GHS categories for surfactants (DASF). The DASF is based on a combination of Reconstructed human Cornea-like Epithelium test methods (OECD TG 492; EpiOcular™ EIT and SkinEthic™ HCE EIT) and the modified Short Time Exposure (STE) test method (0.5% concentration of the test substance after a 5-min exposure). DASF performance was assessed by comparing the prediction results with the historical in vivo data classification and against the criteria established by the OECD expert group on eye/skin. The DASF yielded a balanced accuracy of 80.5% and 90.9% of Cat. 1 (N = 22), 75.0% of Cat. 2 (N = 8), and 75.5% of No Cat. (N = 17) surfactants were correctly predicted. The percentage of mispredictions was below the established maximum values except for in vivo No Cat. surfactants that were over-predicted as Cat. 1 (5.6%, N = 17), with a maximum value set at 5%. The percentage of correct predictions did meet the minimum performance values of 75% Cat. 1, 50% Cat. 2, and 70% No Cat. established by the OECD experts. The DASF has shown to be successful for eye hazard identification of surfactants.


Assuntos
Olho , Surfactantes Pulmonares , Humanos , Animais , Tensoativos/toxicidade , Irritantes/toxicidade , Testes de Toxicidade/métodos , Córnea , Nações Unidas , Alternativas aos Testes com Animais , Reprodutibilidade dos Testes
9.
Ann Ig ; 24(5): 443-7, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23193900

RESUMO

There is a long history to the representation of the Mediterranean Diet Pyramid which may be seen as a form of cultural--culinary evolution as each country applies the foods best suited to its national diet. Different Mediterranean Diet pyramids have been designed for the population of Greece, Spain and Italy, tailored for their different food habits. These refer variously to portion sizes and frequency of consumption--daily, weekly and monthly and are not standardized. The 3rd CIISCAM Conference held in Parma, Italy was devoted to highlight the overall biodiversity and nutritional well being values and the sustainable benefits of the Mediterranean diet, recognised as one of the healthiest dietary pattern, and to reduce the rapid erosion of "lifestyle and food habits. It is necessary, therefore, to refer more to a Mediterranean Lifestyle of which diet is only a part. It should include physical and social activity, recreation and rest. It may be possible to construct a Mediterranean food lifestyle index both to assess such a holistic aspect and to correlate with improved morbidity & mortality.


Assuntos
Dieta Mediterrânea , Necessidades Nutricionais , Humanos , Itália
10.
Ann Ig ; 24(2): 123-30, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22755499

RESUMO

Goal of this work is to promote via on-line applications the knowledge of the Italian Weekly Pyramid, which is based on the concept of WI (Well Being Index) as a unit for a correct lifestyle. On the website www.piramideitaliana.it the user can verify his/her weekly lifestyle by participating in a "game" based on the introduction, for seven consecutive days, of food and beverages consumption and time assigned to physical activity. At the end of the seven days it is possible to access the page with an evaluation of dietary habits together with the possible suggestions for a correct lifestyle. On the basis of the data collected through this web game, a statistical analysis has been developed to evaluate the food habits and the level of physical activity. In the period between September 2005-January 2010 16,546 participants have completed the game. The data collected compare actual WI consumption for each food group with the one suggested by the Pyramid. The sample eating pattern appears almost varied; all the food groups were consumed daily, albeit in much lower quantities with regard to the suggested portions. It is pointed out that some differences in the nutritional habits are related to differences in age groups and in the school degree of the sample analyzed. This work highlights the importance of web-based tailored interventions on population food habits: many people can be reached to promote the knowledge of the guidelines leading to a healthy lifestyle.


Assuntos
Dieta Mediterrânea/estatística & dados numéricos , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Internet , Estilo de Vida , Política Nutricional , Adulto , Inquéritos sobre Dietas , Comportamento Alimentar , Feminino , Educação em Saúde/estatística & dados numéricos , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Atividade Motora , Estudos de Amostragem , Estatísticas não Paramétricas , Inquéritos e Questionários
11.
J Endocrinol Invest ; 34(8): 572-5, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22080647

RESUMO

In the last 15 years, several pharmacological agents for the prevention of fractures have been developed and commercialized. Most of them showed to be effective in reducing fracture risk. The enhanced availability of drugs to prevent fractures has generated a fierce competition among pharmaceutical companies to conquer a share of the potential market, often with claims of superiority of a drug over another without direct comparisons. The definitive way to compare different treatments would require randomized head to head trials. These trials are expensive, need large samples and are unlikely to be ever performed. Therefore, it has become a common practice to compare pharmacological agents through observational studies on administrative databases or by the indirect comparison of the results of individual randomised-controlled trials (RCT) and their meta-analyses. These studies may produce evidence of clinical value, complementary to that given by RCT. However, without a proper and complete analysis, they may result in a biased picture of effectiveness and be completely misleading. In this article, we critically disclose how such competition may produce biased and misleading picture of evidence, by reviewing the significance of the number needed to treat, absolute risk reduction and relative risk reduction in relation to vertebral fractures prevention with available drugs.


Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Fraturas Ósseas/prevenção & controle , Números Necessários para Tratar/normas , Compostos Organometálicos/uso terapêutico , Osteoporose/tratamento farmacológico , Tiofenos/uso terapêutico , Indústria Farmacêutica , Fraturas Ósseas/etiologia , Humanos , Osteoporose/complicações , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
J Endocrinol Invest ; 34(11): e386-91, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21750394

RESUMO

The aim of the study was to estimate the absolute risk of fracture in a sample of postmenopausal women with the Italian version of FRAX®, using femoral neck bone mineral density (BMD) and 3 internationally validated clinical risk factors (CRFs) (history of fragility fracture, family history of hip fracture, current smoking). We retrospectively studied 9586 women (mean age 64.1 yr) examined in three osteoporosis centers from Northern Italy over two years (2001-2002). The risk of major osteoporotic (clinical spine, hip, forearm and humerus) and hip fractures was estimated using the online version of the FRAX algorithm adapted for Italy. The median 10-year risk was 7.5% for osteoporotic fracture and 1.7% for hip fracture. 25% of subjects had a 10-year risk ≥ 12.1% for osteoporotic fracture and ≥ 4.1% for hip fracture. The median 10-year risk of fracture increased with the number of prevalent CRFs. For major osteoporotic fractures risk rose from 6.3% to 10.9%, 21.4% and 40.9% with 1, 2 and 3 prevalent CRFs, respectively. For hip fractures the corresponding figures were: 1.3%, 2.7%, 7.0% and 21.9%, respectively. However, it must be emphasized that in 2 out of 3 women, none of the CRFs examined was present and the assessment of risk was limited to age and BMD. Our data provide the first description of the effect of the combination of BMD, age and CRFs on fracture risk stratification in a large sample of Italian postmenopausal women using FRAX®. The results are a useful starting point to define criteria for the application of FRAX® in clinical practice in Italy.


Assuntos
Colo do Fêmur , Osteoporose Pós-Menopausa/diagnóstico , Osteoporose Pós-Menopausa/epidemiologia , Fraturas por Osteoporose/diagnóstico , Fraturas por Osteoporose/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea/fisiologia , Estudos Transversais , Feminino , Colo do Fêmur/lesões , Colo do Fêmur/patologia , Fraturas do Quadril/diagnóstico , Fraturas do Quadril/epidemiologia , Fraturas do Quadril/etiologia , Humanos , Itália/epidemiologia , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/complicações , Fraturas por Osteoporose/etiologia , Estudos Retrospectivos , Medição de Risco/métodos , Medição de Risco/tendências , Fatores de Risco
13.
Reumatismo ; 63(3): 129-47, 2011 Nov 09.
Artigo em Italiano | MEDLINE | ID: mdl-22257914

RESUMO

The Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS) has elaborated the following guidelines about the definition, prevention and treatment of inadequate vitamin D status. The highlights are presented here. Daily vitamin D allowance ranges from 1,500 IU (healthy adults) to 2,300 IU (elderly with low calcium intake). Since the average Italian diet includes around 300 IU/day, subjects with no effective sun exposure should be supplemented with 1,200-2,000 IU vitamin D per day. The serum 25-hydroxy-vitamin D [25(OH)D] levels represents the most accurate way to assess vitamin D repletion, even though there are still no standardized assay methods. Conditions of "deficiency" and "insufficiency" are defined by the following ranges of 25(OH)D levels: less than 20 ng/ml and 20-30 ng/ml, respectively. In Italy, approximately 50% of young healthy subjects have vitamin D insufficiency during the winter months. The prevalence of deficiency increases with ageing, affecting almost all elderly subjects not on vitamin D supplements. When a condition of deficiency has been identified, a cumulative dose of 300,000-1,000,000 IU, over 1-4 weeks is recommended. In subjects recently treated for deficiency-insufficiency, a maintenance dose of 800-2,000 IU/day (or weekly equivalent) is recommended. In patients on daily doses over 1,000 IU, 25(OH)D levels should be checked regularly (e.g. once every two years). The highest tolerated daily dose has been identified as 4,000 IU/day. Vitamin D supplementation should be carefully monitored in patients at higher risk of vitamin D intoxication (granulomatosis) or with primary hyperparathyroidism. In pregnant women, vitamin D supplements should be given as in non-pregnant women, but bolus administration (i.e.: single dose >25,000 IU) should be avoided.


Assuntos
Deficiência de Vitamina D/prevenção & controle , Adulto , Idoso , Criança , Dieta , Suplementos Nutricionais , Feminino , Fraturas Espontâneas/etiologia , Fraturas Espontâneas/prevenção & controle , Humanos , Dose Máxima Tolerável , Necessidades Nutricionais , Gravidez , Prevalência , Risco , Luz Solar , Vitamina D/administração & dosagem , Vitamina D/efeitos adversos , Vitamina D/fisiologia , Deficiência de Vitamina D/tratamento farmacológico , Deficiência de Vitamina D/epidemiologia
14.
Ann Ig ; 23(2): 161-72, 2011.
Artigo em Italiano | MEDLINE | ID: mdl-21770232

RESUMO

In industrialized Countries malnutrition is a very frequent condition in frail groups of the population, people with low income and elderly subjects above all if institutionalized. The aim of the study is to: analyse the prevalence of malnutrition in a sample of elderly people located in different geographical areas in Italy; identify the psychological, social, economic, environmental, cultural and demographic determinants of malnutrition. The prevalence of malnutrition (estimated through the MNA) is high in both sexes (28% of F and 21.9% of M. Age, institutionalisation, health status, autonomy status, cognitive status and education level are some of the factors that correlate with the presence of malnutrition. Loneliness and poverty seem to have a negative impact on nutritional status but further data are needed to confirm this hypothesis. The data collected confirm the need to activate services dedicated to assess the nutritional status of elderly people, to implement campaigns in particular on food education for the elderly population, to set tools and guide lines for caregivers.


Assuntos
Idoso Fragilizado , Avaliação Geriátrica , Solidão , Desnutrição/epidemiologia , Pobreza/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Cognição , Escolaridade , Feminino , Idoso Fragilizado/psicologia , Nível de Saúde , Humanos , Institucionalização/estatística & dados numéricos , Itália/epidemiologia , Solidão/psicologia , Masculino , Desnutrição/psicologia , Inquéritos Nutricionais , Educação de Pacientes como Assunto/métodos , Pobreza/psicologia , Prevalência , Fatores de Risco
15.
Proc Math Phys Eng Sci ; 477(2245): 20200584, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33633490

RESUMO

By modelling the evaporation and settling of droplets emitted during respiratory releases and using previous measurements of droplet size distributions and SARS-CoV-2 viral load, estimates of the evolution of the liquid mass and the number of viral copies suspended were performed as a function of time from the release. The settling times of a droplet cloud and its suspended viral dose are significantly affected by the droplet composition. The aerosol (defined as droplets smaller than 5 µm) resulting from 30 s of continued speech has O(1 h) settling time and a viable viral dose an order-of-magnitude higher than in a short cough. The time-of-flight to reach 2 m is only a few seconds resulting in a viral dose above the minimum required for infection, implying that physical distancing in the absence of ventilation is not sufficient to provide safety for long exposure times. The suspended aerosol emitted by continuous speaking for 1 h in a poorly ventilated room gives 0.1-11% infection risk for initial viral loads of 10 8 - 10 10 copies ml l - l , respectively, decreasing to 0.03-3% for 10 air changes per hour by ventilation. The present results provide quantitative estimates useful for the development of physical distancing and ventilation controls.

16.
J Exp Med ; 177(3): 797-809, 1993 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-8436910

RESUMO

Mice with transgenes containing an antibody H chain V region (VHDJH) gene were used in an analysis of the cis-acting elements required for hypermutation of immunoglobulin (Ig) V genes. These transgenes can somatically recombine with endogenous IgH DNA, leading to the formation of functional heavy (H) chains partially encoded by the transgenic VHDJH. The transgenomes in the five different lines of mice analyzed contain as little as 150 bp, and as much as 2.8 kb of natural DNA flanking the 5' side of the VH and either 1.5 or 2.3 kb (including the intronic enhancer and 5' matrix attachment region [MAR]) flanking the 3' side of VH. Hybridomas were constructed from immunized transgenic mice, and transgenes present in these hybridomas that had or had not recombined to form functional H chain loci were sequenced. The data obtained show that: (a) the recombined transgenes contain hypermutated VH genes; and (b) among such transgenes, even those containing only 150 bp of natural VH 5' flanking sequence and several kilobases of 5' plasmid vector sequence display a frequency, distribution, and type of mutation characteristic of conventional IgH loci. The data also indicate that transgenic VHDJH genes that have not recombined with endogenous IgH DNA are not substrates for hypermutation, even if they are flanked by 2.8 kb of natural 5' DNA, and 2.3 kb of natural 3' DNA, including the JH2-JH4 region, a MAR, and the intronic enhancer. Collectively, the data suggest that sequences 5' of the VH promoter are dispensable, a VH promoter and the intronic IgH enhancer region are not sufficient, and a region(s) within or 3' of the IgH constant region locus is requisite, for hypermutation of Ig VH transgenes.


Assuntos
DNA/genética , Elementos Facilitadores Genéticos/genética , Cadeias Pesadas de Imunoglobulinas/genética , Região Variável de Imunoglobulina/genética , Mutação/genética , Regiões Promotoras Genéticas/genética , Transfecção/genética , Animais , Sequência de Bases , Mapeamento Cromossômico , Feminino , Regulação Neoplásica da Expressão Gênica/genética , Vetores Genéticos , Hibridomas/patologia , Masculino , Camundongos , Camundongos Transgênicos , Dados de Sequência Molecular
17.
J Exp Med ; 179(1): 235-48, 1994 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-8270869

RESUMO

We have constructed lines of mice with transgenes containing an antibody heavy (H) chain variable region (VHDJH) gene and various amounts of natural immunoglobulin (Ig) and plasmid flanking DNA. In these lines, recombination of the transgene and the endogenous Igh locus takes place in B cells, leading to the expression of functional H chains partially encoded by the transgenic VHDJH gene. Here, we demonstrate that the transgenic VHDJH gene, and various amounts of flanking sequence are recombined with Igh locus DNA via interchromosomal gene conversion. The structures of the resulting "hybrid" transgene-Igh H chain loci are consistent with the 3' end of the conversion occurring in regions of sequence identity, and the 5' end taking place between regions of little or no homology. This mode of antibody transgene recombination with the Igh locus is fundamentally different from the previously reported "trans H chain class switching" that results in reciprocal translocations. In contrast, this recombination resembles events previously observed in mammalian tissue culture cells between adjacent homologous chromosomal sequences, or transfected DNA and a homologous chromosomal target. Our data indicate that this recombination takes place at a low frequency, and that the frequency is influenced by both the length and extent of homology between the transgene and the Igh locus, but is not greatly affected by transgene copy number. This recombination pathway provides a novel approach for the subtle alteration of the clonal composition of the mouse B cell compartment in vivo using VH genes with defined structures and functions.


Assuntos
Conversão Gênica , Cadeias Pesadas de Imunoglobulinas/genética , Alelos , Animais , Southern Blotting , Linhagem Celular , Cromossomos , Troca Genética , DNA/genética , Eletroforese em Gel de Ágar , Eletroforese em Gel de Campo Pulsado , Região Variável de Imunoglobulina/genética , Hibridização in Situ Fluorescente , Camundongos , Camundongos Transgênicos , Modelos Genéticos , Reação em Cadeia da Polimerase , Recombinação Genética , Baço/metabolismo
18.
Int J Food Microbiol ; 333: 108812, 2020 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-32805575

RESUMO

The aim of this study was to evaluate the occurrence, infection level and distribution of ascaridoid larvae in cephalopod products sold in Italy. Data on the species most commonly commercialized as whole and fresh on the Italian market were collected. After comparing commercial and literature data, Eledone spp., comprising E. cirrhosa and E. moschata (horned octopus and musky octopus, respectively) and Doryteuthis pealeii (longfin inshore squid) were selected, as they had been rarely investigated. Overall, 75 Eledone spp. caught in the Mediterranean Sea (FAO area 37) and 70 D. pealeii from the Northwest Atlantic Ocean (FAO area 21) were examined by visual inspection and artificial digestion (viscera and mantle separately). Parasites were submitted to morphological and molecular analysis. Prevalence (P), mean intensity (MI) and mean abundance (MA) were calculated. In D. pealeii, 2 nematode larvae molecularly identified as Anisakis simplex s.s. were found in the viscera and in the mantle of two specimens (P: 2.9% 95% CI: 0-6.8%; MI: 1; MA: 0.028). In Eledone spp. 9 nematode larvae molecularly attributed to Hysterothylacium spp. were found in the mantle of 5 specimens (P: 6.7% 95% CI: 1-12.3%; MI: 1.8; MA: 0.12). This is the first report of A. simplex s.s. in D. pealeii. Considering the zoonotic and allergenic potential of these larvae and their localization also in the edible part (mantle), a potential public health issue exists.


Assuntos
Anisaquíase/veterinária , Anisakis/isolamento & purificação , Decapodiformes/parasitologia , Octopodiformes/parasitologia , Alimentos Marinhos/parasitologia , Animais , Anisaquíase/parasitologia , Anisakis/classificação , Oceano Atlântico , Peixes/parasitologia , Parasitologia de Alimentos , Itália , Larva , Mar Mediterrâneo
19.
Science ; 222(4625): 721-6, 1983 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-6356353

RESUMO

Hybridoma technology has made it possible to introduce into continuous culture normal antibody-forming cells and to obtain large amounts of the immunoglobulin produced by each of these cells. Examination of the structure of a number of monoclonal antibodies that react with a single antigen has provided new information on the structural basis of the specificity and affinity of antibodies. Comparisons of families of monoclonal antibodies derived from a single germ line gene revealed the importance of somatic mutation in generating antibody diversity. Monoclonal antibodies that react with variable regions of other monoclonals allow the further dissection and modulation of the immune response. Finally, the continued somatic instability of immunoglobulin genes in cultured antibody-forming cells makes it possible to determine the rate of somatic mutation and to generate mutant monoclonal antibodies that may be more effective serological reagents.


Assuntos
Anticorpos Monoclonais/imunologia , Diversidade de Anticorpos , Sequência de Aminoácidos , Animais , Anticorpos Monoclonais/genética , Especificidade de Anticorpos , Genes , Hibridomas/imunologia , Idiótipos de Imunoglobulinas/imunologia , Região Variável de Imunoglobulina/genética , Camundongos , Mutação , Conformação Proteica , Relação Estrutura-Atividade
20.
Waste Manag ; 29(5): 1467-72, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19103480

RESUMO

The concurrent effects of a fast national growth rate, of a large and dense residential area and a pressing demand for urban environmental protection create a challenging framework for waste management in Pudong New Area, Shanghai. The complexity of context and procedures is indeed a primary concern of local municipal authorities due to problems related to the collection, transportation and processing of residential solid waste. In order to design and implement a suitable urban solid waste system, the first task is to forecast the quantity and variance of solid waste as it relates to residential population, consumer index, season, etc. The system here discussed addresses exactly these issues, by means of an intelligent, sensorized container. The container has been prepared and tested in the Pudong New Area, Shanghai.


Assuntos
Eliminação de Resíduos/instrumentação , Eliminação de Resíduos/métodos , China , Sistemas de Informação Geográfica , Telemetria , População Urbana
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