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2.
Pulmonology ; 29(3): 194-199, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-34233862

RESUMO

INTRODUCTION: The management and treatment of Chronic Obstructive Pulmonary Disease (COPD) are based on a cutoff point either of ≥ 10 on the COPD Assessment Test (CAT) or of ≥ 2 of the Medical Research Council (mMRC). Up to now, no study has assessed the equivalence between CAT and mMRC, as related to exercise tolerance in COPD. The aim of this study was to investigate as primary outcome the relationship between CAT and mMRC and maximal exercise capacity in COPD patients. We also evaluated as secondary outcome the agreement between CAT (≥ 10) and mMRC (≥ 2) to categorize patients according to their exercise tolerance. MATERIAL AND METHODS: 118 consecutive COPD patients (39 females), aged between 47 and 85 years with a wide range of airflow obstruction and lung hyperinflation were studied. Maximal exercise capacity was assessed by cardiopulmonary exercise test. RESULTS: CAT and mMRC scores were significantly related to VO2 peak (p<0.01). CAT (≥ 10) and mMRC (≥ 2) have a high likelihood to be associated to a value of VO2 peak less than 15.7 and 15.6 mL/kg/min, respectively. The interrater agreement between CAT (≥ 10) and mMRC (≥ 2) was found to be fair (κ = 0.20) in all patients but slight when they were subdivided in those with VO2 peak < 15 mL/kg/min and in those with VO2 peak ≥ 15 mL/kg/min (κ = 0.10 and κ = 0.20 respectively). CONCLUSION: This study shows that CAT and mMRC are useful tools to predict exercise tolerance in COPD, but they cannot be considered as supplementary measures.


Assuntos
Pesquisa Biomédica , Doença Pulmonar Obstrutiva Crônica , Feminino , Humanos , Tolerância ao Exercício , Dispneia , Índice de Gravidade de Doença
3.
J Asthma ; 59(1): 23-30, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-32962473

RESUMO

Background: Although the etiology and disease mechanisms of asthma and alpha-1 antitrypsin deficiency (AATD) are distinct, several reports indicate that asthma is common in AATD patients, however the relationships between asthma and AATD are poorly described in the literature.Objectives: The aim of the study was to investigate in a cohort of outpatients affected by mild to moderate asthma the clinical features that may differentiate asthmatic patients with and without mutation on SERPINA1 gene.Methods: Seven hundred thirty-five asthmatic outpatients underwent quantitative analysis of the serum level of alpha-1antitrypsin. According to the literature only sixty-seven out of seven hundred thirty-five asthmatic patients were submitted to genetic analysis to identify AATD and non-AATD subjects. Fifty-eight patients were studied. Clinical and functional data, including lung function, atopy and bronchial hyperactivity, were recorded.Results: The fifty-eight asthmatic patients were divided in AATD patients (n = 22) and non AATD patients (n = 36), according to genotype. The presence of atopy was significantly higher in patients with AATD than in those without AATD (91% vs. 64%; p = 0.031). AATD patients reported allergic manifestations more than non AATD patients (77% vs. 47%; p = 0.030).Conclusion: Our study shows that the presence of atopy in asthmatic patients with AATD is significantly higher than in asthmatic patients without gene mutation. In addition, a higher percentage of AATD patients self-reported allergic manifestations. No significant differences in respiratory symptoms, physical examination, disease severity or inflammation markers were found between AATD patients and non AATD patients.


Assuntos
Asma , Deficiência de alfa 1-Antitripsina , Asma/diagnóstico , Testes Genéticos , Genótipo , Humanos , alfa 1-Antitripsina/genética , Deficiência de alfa 1-Antitripsina/complicações , Deficiência de alfa 1-Antitripsina/epidemiologia , Deficiência de alfa 1-Antitripsina/genética
4.
Appetite ; 169: 105827, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-34843753

RESUMO

Obesity has been associated with increased reward sensitivity to food stimuli, but a few studies have addressed this issue by using odors. This study investigated whether obesity is associated with increased liking and wanting of food odors and whether alexithymia, a psychological construct characterized by diminished affective abilities, contributes to altered responsiveness to food. Liking and wanting for food and pleasant non-food odors were measured through explicit (self-report ratings) and implicit measures (heart rate and skin conductance) in 23 women with healthy weight (HW) and 20 women with overweight/obesity (OW/OB). Differently from the HW group, the OW/OB group explicitly liked food odors less than non-food odors; but, at the implicit level, there were no differences in heart rate response for both types of odors, indicating that they were equally liked. Moreover, at variance with the HW group, the OW/OB group did not exhibit increased skin conductance response for food compared to nonfood odors. Alexithymia was associated with increased implicit liking and explicit wanting of food odors, in particular in the HW group. These findings show that obesity is characterized by high levels of implicit food liking and low levels of implicit food wanting. Moreover, both affective and motivational responses to food reward seem to be affected by alexithymia, which should be taken into account by studies evaluating the effect of cue exposure intervention for obesity treatment.


Assuntos
Sintomas Afetivos , Sinais (Psicologia) , Feminino , Alimentos , Preferências Alimentares/psicologia , Humanos , Obesidade , Recompensa
5.
Neuroimage ; 229: 117725, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33484850

RESUMO

Previous studies have shown that individuals with overweight and obesity may experience attentional biases and reduced inhibition toward food stimuli. However, evidence is scarce as to whether the attentional bias is present even before stimuli are consciously recognized. Moreover, it is not known whether or not differences in the underlying brain morphometry and connectivity may co-occur with attentional bias and impulsivity towards food in individuals with different BMIs. To address these questions, we asked fifty-three participants (age M = 23.2, SD = 2.9, 13 males) to perform a breaking Continuous Flash Suppression (bCFS) task to measure the speed of subliminal processing, and a Go/No-Go task to measure inhibition, using food and nonfood stimuli. We collected whole-brain structural magnetic resonance images and functional resting-state activity. A higher BMI predicted slower subliminal processing of images independently of the type of stimulus (food or nonfood, p = 0.001, εp2 = 0.17). This higher threshold of awareness is linked to lower grey matter (GM) density of key areas involved in awareness, high-level sensory integration, and reward, such as the orbitofrontal cortex [t = 4.55, p = 0.003], the right temporal areas [t = 4.18, p = 0.002], the operculum and insula [t = 4.14, p = 0.005] only in individuals with a higher BMI. In addition, individuals with a higher BMI exhibit a specific reduced inhibition to food in the Go/No-Go task [p = 0.02, εp2 = 0.02], which is associated with lower GM density in reward brain regions [orbital gyrus, t = 4.97, p = 0.005, and parietal operculum, t = 5.14, p < 0.001] and lower resting-state connectivity of the orbital gyrus to visual areas [fusiform gyrus, t = -4.64, p < 0.001 and bilateral occipital cortex, t = -4.51, p < 0.001 and t = -4.34, p < 0.001]. Therefore, a higher BMI is predictive of non food-specific slower visual subliminal processing, which is linked to morphological alterations of key areas involved in awareness, high-level sensory integration, and reward. At a late, conscious stage of visual processing a higher BMI is associated with a specific bias towards food and with lower GM density in reward brain regions. Finally, independently of BMI, volumetric variations and connectivity patterns in different brain regions are associated with variability in bCFS and Go/No-Go performances.


Assuntos
Viés de Atenção/fisiologia , Índice de Massa Corporal , Córtex Cerebral/fisiologia , Inibição Psicológica , Rede Nervosa/fisiologia , Obesidade/fisiopatologia , Adulto , Córtex Cerebral/diagnóstico por imagem , Feminino , Alimentos , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Rede Nervosa/diagnóstico por imagem , Obesidade/diagnóstico por imagem , Tamanho do Órgão , Estimulação Luminosa/métodos , Desempenho Psicomotor/fisiologia , Descanso/fisiologia , Recompensa , Adulto Jovem
6.
Neural Plast ; 2020: 4838291, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32952547

RESUMO

The present study explores the correlation between electroencephalographic and neuroimaging asymmetry index from EEG-MRI functional connectome and EEG power analysis in inattention, motion, and mixed profile subgroups of ADHD. Sixty-two subjects from Healthy Brain Network Biobank of the Child Mind Institute dataset were selected basing on the quotient score. From both MRI and EEG asymmetry index, Pearson's correlation, ANOVA, and partial least square analysis were performed matching left and right brain parcels and channels. The asymmetry index significantly correlated across subjects between fMRI and power-EEG in the inattention group in frontal and temporal areas for theta and alpha bands, an anticorrelation in the same areas for delta band was found. Significant patterns of hemispheric asymmetry index have been reported, involving EEG bands that underlie cognitive impairments in ADHD. Alpha and theta bands were altered in the inattention group of patients, reflecting widespread deficiency of basic attentional processing.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Encéfalo/fisiopatologia , Adulto , Ondas Encefálicas , Conectoma , Eletroencefalografia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Adulto Jovem
7.
Contrast Media Mol Imaging ; 2019: 1071453, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31275082

RESUMO

3D printing and reverse engineering are innovative technologies that are revolutionizing scientific research in the health sciences and related clinical practice. Such technologies are able to improve the development of various custom-made medical devices while also lowering design and production costs. Recent advances allow the printing of particularly complex prototypes whose geometry is drawn from precise computer models designed on in vivo imaging data. This review summarizes a new method for histological sample processing (applicable to e.g., the brain, prostate, liver, and renal mass) which employs a personalized mold developed from diagnostic images through computer-aided design software and 3D printing. Through positioning the custom mold in a coherent manner with respect to the organ of interest (as delineated by in vivo imaging data), the cutting instrument can be precisely guided in order to obtain blocks of tissue which correspond with high accuracy to the slices imaged. This approach appeared crucial for validation of new quantitative imaging tools, for an accurate imaging-histopathological correlation and for the assessment of radiogenomic features extracted from oncological lesions. The aim of this review is to define and describe 3D printing technologies which are applicable to oncological assessment and slicer design, highlighting the radiological and pathological perspective as well as recent applications of this approach for the histological validation of and correlation with MR images.


Assuntos
Imageamento Tridimensional/métodos , Imageamento por Ressonância Magnética/métodos , Impressão Tridimensional/instrumentação , Animais , Desenho Assistido por Computador/tendências , Técnicas Histológicas/instrumentação , Técnicas Histológicas/tendências , Humanos , Imageamento por Ressonância Magnética/tendências , Ciência de Laboratório Médico/instrumentação , Ciência de Laboratório Médico/tendências , Impressão Tridimensional/tendências
8.
J Neurol ; 266(5): 1113-1119, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30762102

RESUMO

Although deep brain stimulation of the subthalamic nucleus is an effective surgical treatment for Parkinson's disease, it may expose patients to non-motor side effects such as increased impulsivity and changes in decision-making behavior. Even if several studies have shown that stimulation of the subthalamic nucleus increases the incentive salience of food rewards in both humans and animals, temporal discounting for food rewards has never been investigated in patients who underwent STN-DBS. In this study, we measured inter-temporal choice after STN-DBS, using both primary and secondary rewards. In particular, PD patients who underwent STN-DBS (in ON medication/ON stimulation), PD patients without STN-DBS (in ON medication) and healthy matched controls (C) performed three temporal discounting tasks with food (primary reward), money and discount vouchers (secondary rewards). Participants performed also neuropsychological tests assessing memory and executive functions. Our results show that STN-DBS patients and PD without DBS behave as healthy controls. Even PD patients who after DBS experienced weight gain and/or eating alterations did not show an increased temporal discounting for food rewards. Interestingly, patients taking a higher dosage of dopaminergic medications, fewer years from DBS surgery and, unexpectedly, with better episodic memory were also those who discounted rewards more. In conclusion, this study shows that STN-DBS does not affect temporal discounting of primary and secondary rewards. Furthermore, by revealing interesting correlations between clinical measures and temporal discounting, it also shed light on the clinical outcomes that follow STN-DBS in patients with PD.


Assuntos
Estimulação Encefálica Profunda/métodos , Desvalorização pelo Atraso/fisiologia , Doença de Parkinson/terapia , Recompensa , Núcleo Subtalâmico/fisiologia , Idoso , Comportamento de Escolha , Correlação de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estimulação Luminosa , Estatísticas não Paramétricas
9.
J Endocrinol Invest ; 41(11): 1307-1315, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29574529

RESUMO

PURPOSE: Laparoscopic sleeve gastrectomy (LSG) is one of the most frequently performed bariatric surgery interventions because of its safety and efficacy. Nevertheless, concerns have been raised on its detrimental effect on patient nutritional state that can ultimately lead to the loss of fat-free mass (FFM). There is interest in identifying predictors for the early identification of patients at risk of this highly unwanted adverse because they could benefit of nutritional preventive interventions. Therefore, we investigated whether anthropometric parameters, body composition or resting energy expenditure (REE) measured before surgery could predict FFM loss 1 year after LSG. METHODS: Study design was retrospective observational. We retrieved data on body weight, BMI, body composition and REE before and 1 year after LSG from the medical files of 36 patients operated on by LSG at our institutions. Simple regression, the Oldham's method and multilevel analysis were used to identify predictors of FFM loss. RESULTS: Averaged percentage FFM loss 1 year after LSG was 17.0 ± 7.7% with significant differences between sexes (20.8 ± 6.6 in males and 12.2 ± 6.1% in females, p < 0.001). FFM loss was strongly predicted by pre-surgery FFM and this effect persisted also after correcting for the contribution of sex. CONCLUSIONS: High FFM values before surgery predict a more severe FFM loss after LSG. This factor could also account for the higher FFM loss in men than in women. Our finding could help in the early identification of patient requiring a nutritional support after LSG.


Assuntos
Tecido Adiposo/fisiopatologia , Composição Corporal/fisiologia , Gastrectomia/métodos , Obesidade Mórbida/cirurgia , Redução de Peso/fisiologia , Adulto , Índice de Massa Corporal , Metabolismo Energético/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/fisiopatologia , Estudos Retrospectivos , Fatores Sexuais
10.
Ecotoxicol Environ Saf ; 154: 237-244, 2018 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-29476973

RESUMO

The use of engineered nanomaterials (ENMs) for environmental remediation, known as nanoremediation, represents a challenging and innovative solution, ensuring a quick and efficient removal of pollutants from contaminated sites. Although the growing interest in nanotechnological solutions for pollution remediation, with significant economic investment worldwide, environmental and human risk assessment associated with the use of ENMs is still a matter of debate and nanoremediation is seen yet as an emerging technology. Innovative nanotechnologies applied to water and soil remediation suffer for a proper environmental impact scenario which is limiting the development of specific regulatory measures and the exploitation at European level. The present paper summarizes the findings from the workshop: "Ecofriendly Nanotechnology: state of the art, future perspectives and ecotoxicological evaluation of nanoremediation applied to contaminated sediments and soils" convened during the Biannual ECOtoxicology Meeting 2016 (BECOME) held in Livorno (Italy). Several topics have been discussed and, starting from current state of the art of nanoremediation, which represents a breakthrough in pollution control, the following recommendations have been proposed: (i) ecosafety has to be a priority feature of ENMs intended for nanoremediation; ii) predictive safety assessment of ENMs for environmental remediation is mandatory; (iii) greener, sustainable and innovative nano-structured materials should be further supported; (iii) those ENMs that meet the highest standards of environmental safety will support industrial competitiveness, innovation and sustainability. The workshop aims to favour environmental safety and industrial competitiveness by providing tools and modus operandi for the valorization of public and private investments.


Assuntos
Recuperação e Remediação Ambiental , Nanoestruturas , Nanotecnologia , Consenso , Ecotoxicologia , Poluição Ambiental , Poluentes do Solo , Poluição da Água
11.
Physiol Behav ; 188: 18-24, 2018 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-29378188

RESUMO

The estimates we do of the energy content of different foods tend to be inaccurate, depending on several factors. The elements influencing such evaluation are related to the differences in the portion size of the foods shown, their energy density (kcal/g), but also to individual differences of the estimators, such as their body-mass index (BMI) or eating habits. Within this context the contribution of brain regions involved in food-related decisions to the energy estimation process is still poorly understood. Here, normal-weight and overweight/obese women with restrained or non-restrained eating habits, received anodal transcranial direct current stimulation (AtDCS) to modulate the activity of the left dorsolateral prefrontal cortex (dlPFC) while they performed a food energy estimation task. Participants were asked to judge the energy content of food images, unaware that all foods, for the quantity presented, shared the same energy content. Results showed that food energy density was a reliable predictor of their energy content estimates, suggesting that participants relied on their knowledge about the food energy density as a proxy for estimating food energy content. The neuromodulation of the dlPFC interacted with individual differences in restrained eating, increasing the precision of the energy content estimates in participants with higher scores in the restrained eating scale. Our study highlights the importance of eating habits, such as restrained eating, in modulating the activity of the left dlPFC during food appraisal.


Assuntos
Afeto/fisiologia , Encéfalo/fisiologia , Metabolismo Energético/fisiologia , Comportamento Alimentar/fisiologia , Córtex Pré-Frontal/fisiologia , Adolescente , Adulto , Índice de Massa Corporal , Feminino , Humanos , Obesidade/fisiopatologia , Obesidade/psicologia , Sobrepeso/fisiopatologia , Sobrepeso/psicologia , Estimulação Luminosa , Estimulação Transcraniana por Corrente Contínua , Adulto Jovem
12.
Brain Imaging Behav ; 11(4): 1117-1128, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-27704405

RESUMO

Irritable bowel syndrome (IBS) is characterized by visceral hypersensitivity likely related to altered processing of sensory stimuli along the brain-gut axis. Previous neuroimaging studies demonstrated structural and functional alteration of several brain areas involved in bodily representation, e.g. the insula, in patients with IBS. By means of resting-state functional magnetic resonance imaging (rs-fMRI) we searched for alteration of functional connectivity within the network involved in self-bodily consciousness. We found significant inverse correlation between hypochondriasis assessed through a clinical questionnaire and connectivity between posterior cingulate cortex and left supramarginal gyrus, extending into the adjacent superior temporal gyrus. Moreover, we observed a significant and positive correlation between a clinical questionnaire assessing interoception and connectivity between left anterior ventral insula and two clusters located in supramarginal gyrus bilaterally.Our findings highlight an "abnormal network synchrony" reflecting functional alteration, in the absence of structural and micro-structural changes, which might represent a possible therapeutic target for Irritable Bowel Syndrome.


Assuntos
Encéfalo/fisiopatologia , Interocepção , Síndrome do Intestino Irritável/fisiopatologia , Síndrome do Intestino Irritável/psicologia , Adulto , Idoso , Conscientização , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Feminino , Humanos , Síndrome do Intestino Irritável/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Vias Neurais/diagnóstico por imagem , Vias Neurais/fisiopatologia , Testes Neuropsicológicos , Inquéritos e Questionários , Adulto Jovem
13.
J Biomed Inform ; 63: 141-149, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27498066

RESUMO

The emergence of wearables and smartwatches is making sensors a ubiquitous technology to measure daily rhythms in physiological measures, such as movement and heart rate. An integration of sensor data from wearables and self-report questionnaire data about cognition, behaviors, and emotions can provide new insights into the interaction of mental and physiological processes in daily life. Hitherto no method existed that enables an easy-to-use integration of sensor and self-report data. To fill this gap, we present 'Physiqual', a platform for researchers that gathers and integrates data from commercially available sensors and service providers into one unified format for use in Ecological Momentary Assessments (EMA) or Experience Sampling Methods (ESM), and Quantified Self (QS). Physiqual currently supports sensor data provided by two well-known service providers and therewith a wide range of smartwatches and wearables. To demonstrate the features of Physiqual, we conducted a case study in which we assessed two subjects by means of data from an EMA study combined with sensor data as aggregated and exported by Physiqual. To the best of our knowledge, the Physiqual platform is the first platform that allows researchers to conveniently aggregate and integrate physiological sensor data with EMA studies.


Assuntos
Cognição , Avaliação Momentânea Ecológica , Projetos de Pesquisa , Dispositivos Eletrônicos Vestíveis , Coleta de Dados , Humanos , Inquéritos e Questionários
14.
Eur J Radiol ; 84(7): 1269-76, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25958189

RESUMO

PURPOSE: To evaluate the role of simultaneous hybrid PET/MR imaging and to correlate metabolic PET data with morpho-functional parameters derived by MRI in patients with head-neck cancer. METHODS: Forty-four patients, with histologically confirmed head and neck malignancy (22 primary tumors and 22 follow-up) were studied. Patients initially received a clinical exam and endoscopy with direct biopsy. Next patients underwent whole body PET/CT followed by PET/MR of the head/neck region. PET and MRI studies were separately evaluated by two blinded groups (both included one radiologist and one nuclear physician) in order to define the presence or absence of lesions/recurrences. Regions of interest (ROIs) analysis was conducted on the primary lesion at the level of maximum size on metabolic (SUV and MTV), diffusion (ADC) and perfusion (K(trans), Ve, kep and iAUC) parameters. RESULTS: PET/MR examinations were successfully performed on all 44 patients. Agreement between the two blinded groups was found in anatomic allocation of lesions by PET/MR (Primary tumors: Cohen's kappa 0.93; FOLLOW-UP: Cohen's kappa 0.89). There was a significant correlation between CT-SUV measures and MR (e.g., CT-SUV VOI vs. MR-SUV VOI: ρ=0.97, p<0.001 for the entire sample). There was also significant positive correlations between the ROI area, SUV measures, and the metabolic parameters (SUV and MTV) obtained during both PET/CT and PET/MR. A significant negative correlation was observed between ADC and K(trans) values in the primary tumors. In addition, a significant negative correlation existed between MR SUV and ADC in recurrent tumors. CONCLUSION: Our study demonstrates the feasibility of PET/MR imaging for primary tumors and recurrent tumors evaluations of head/neck malignant lesions. When assessing HNC, PET/MR allows simultaneous collection of multiparametric metabolic and functional data. This technique therefore allows for a more complete characterization of malignant lesions.


Assuntos
Imagem de Difusão por Ressonância Magnética , Neoplasias de Cabeça e Pescoço/diagnóstico , Imagem Multimodal/métodos , Tomografia por Emissão de Pósitrons , Imagem de Difusão por Ressonância Magnética/métodos , Estudos de Viabilidade , Feminino , Fluordesoxiglucose F18 , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos
15.
Obes Surg ; 25(12): 2344-51, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25948283

RESUMO

BACKGROUND: We evaluated dietary intakes, body composition, micronutrient deficiency, and response to micronutrient supplementation in 47 patients before and for 6 months after laparoscopic sleeve gastrectomy (LSG). METHODS: Before, 3, and 6 months after LSG, we measured dietary intakes with food-frequency questionnaires, body composition with bioimpedance analysis (BIA) and bioelectrical vector analysis (BIVA), and plasma concentrations of iron, Zn, water-, and lipo-soluble vitamins. RESULTS: After LSG, energy intake significantly decreased and patients lost weight, fat mass, and free-fat mass. BIVA showed a substantial loss of soft tissue body cell mass (BCM) with no change in hydration. Before surgery, 15 % of patients were iron deficient, 30 % had low levels of zinc and/or water-soluble vitamins, and 32 % of vitamin 25(OH)-D3. We treated iron deficiency with ferrous sulfate, isolated folate deficiency with N5-methyiltetrahydrofolate-Ca-pentahydrate, and deficiencies in vitamin B1, B12, or Zn, with or without concomitant folate deficiency, with multivitamin. No supplementation was given to vitamin 25(OH)-D3 deficient patients. At first follow-up, 7 % of patients developed new deficiencies in iron, 7 % in folic acid (n = 3), and 36 % in water-soluble vitamins and/or zinc whereas no new deficit in vitamin 25(OH)-D3 occurred. At final follow-up, deficiencies were corrected in all patients treated with either iron or folate but only in 32 % of those receiving multivitamin. Vitamin 25(OH)-D3 deficiency was corrected in 73 % of patients even though these patients were not supplemented. CONCLUSION: LSG-induced weight loss is accompanied by a decrease in BCM with no body fluid alterations. Deficiencies in water-soluble vitamins and Zn respond poorly to multivitamin supplementation.


Assuntos
Composição Corporal/fisiologia , Suplementos Nutricionais , Micronutrientes/administração & dosagem , Obesidade Mórbida/dietoterapia , Obesidade Mórbida/cirurgia , Adulto , Deficiência de Vitaminas/epidemiologia , Deficiência de Vitaminas/etiologia , Deficiência de Vitaminas/prevenção & controle , Feminino , Ácido Fólico/sangue , Deficiência de Ácido Fólico/etiologia , Gastrectomia/efeitos adversos , Humanos , Laparoscopia/efeitos adversos , Masculino , Micronutrientes/farmacologia , Pessoa de Meia-Idade , Terapia Nutricional , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/metabolismo , Complicações Pós-Operatórias/prevenção & controle , Período Pós-Operatório , Estudos Retrospectivos , Oligoelementos/sangue , Vitaminas/sangue , Adulto Jovem
16.
AJNR Am J Neuroradiol ; 36(6): 1096-101, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25882284

RESUMO

BACKGROUND AND PURPOSE: The ability of DTI to track the progression of microstructural damage in patients with inherited ataxias has not been explored so far. We performed a longitudinal DTI study in patients with spinocerebellar ataxia type 2. MATERIALS AND METHODS: Ten patients with spinocerebellar ataxia type 2 and 16 healthy age-matched controls were examined twice with DTI (mean time between scans, 3.6 years [patients] and 3.3 years [controls]) on the same 1.5T MR scanner. Using tract-based spatial statistics, we analyzed changes in DTI-derived indices: mean diffusivity, axial diffusivity, radial diffusivity, fractional anisotropy, and mode of anisotropy. RESULTS: At baseline, the patients with spinocerebellar ataxia type 2, as compared with controls, showed numerous WM tracts with significantly increased mean diffusivity, axial diffusivity, and radial diffusivity and decreased fractional anisotropy and mode of anisotropy in the brain stem, cerebellar peduncles, cerebellum, cerebral hemisphere WM, corpus callosum, and thalami. Longitudinal analysis revealed changes in axial diffusivity and mode of anisotropy in patients with spinocerebellar ataxia type 2 that were significantly different than those in the controls. In patients with spinocerebellar ataxia type 2, axial diffusivity was increased in WM tracts of the right cerebral hemisphere and the corpus callosum, and the mode of anisotropy was extensively decreased in hemispheric cerebral WM, corpus callosum, internal capsules, cerebral peduncles, pons and left cerebellar peduncles, and WM of the left paramedian vermis. There was no correlation between the progression of changes in DTI-derived indices and clinical deterioration. CONCLUSIONS: DTI can reveal the progression of microstructural damage of WM fibers in the brains of patients with spinocerebellar ataxia type 2, and mode of anisotropy seems particularly sensitive to such changes. These results support the potential of DTI-derived indices as biomarkers of disease progression.


Assuntos
Encéfalo/patologia , Imagem de Difusão por Ressonância Magnética/métodos , Interpretação de Imagem Assistida por Computador , Ataxias Espinocerebelares/diagnóstico , Ataxias Espinocerebelares/patologia , Adulto , Anisotropia , Mapeamento Encefálico , Estudos de Casos e Controles , Progressão da Doença , Feminino , Predisposição Genética para Doença , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Ataxias Espinocerebelares/genética
17.
J Biomech ; 47(11): 2547-55, 2014 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-24998989

RESUMO

Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure introduced to treat aortic valve stenosis in elder patients. Its clinical outcomes are strictly related to patient selection, operator skills, and dedicated pre-procedural planning based on accurate medical imaging analysis. The goal of this work is to define a finite element framework to realistically reproduce TAVI and evaluate the impact of aortic root anatomy on procedure outcomes starting from two real patient datasets. Patient-specific aortic root models including native leaflets, calcific plaques extracted from medical images, and an accurate stent geometry based on micro-tomography reconstruction are key aspects included in the present study. Through the proposed simulation strategy we observe that, in both patients, stent apposition significantly induces anatomical configuration changes, while it leads to different stress distributions on the aortic wall. Moreover, for one patient, a possible risk of paravalvular leakage has been found while an asymmetric coaptation occurs in both investigated cases. Post-operative clinical data, that have been analyzed to prove reliability of the performed simulations, show a good agreement with analysis results. The proposed work thus represents a further step towards the use of realistic computer-based simulations of TAVI procedures, aiming at improving the efficacy of the operation technique and supporting device optimization.


Assuntos
Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Próteses Valvulares Cardíacas , Idoso de 80 Anos ou mais , Calcinose , Cateterismo , Simulação por Computador , Análise de Elementos Finitos , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Modelos Anatômicos , Reprodutibilidade dos Testes , Stents , Tomografia Computadorizada por Raios X
18.
Eur J Phys Rehabil Med ; 50(4): 427-32, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24955593

RESUMO

BACKGROUND: Cough efficacy assessment is of clinical relevance in neuromuscular patients. Tests of varying complexity and invasiveness, such as cough peak flow (CPF), maximal expiratory pressure (PEmax) and gastric pressure during cough (Cough Pgas) are routinely available. AIM: To assess the value of CPF, PEmax and Cough Pgas in the detection of ineffective cough in patients suffering from neuromuscular diseases. DESIGN: Prospective observational study. SETTING: Outpatient laboratory for respiratory muscle function assessment. POPULATION: Forty-nine patients with neuromuscular diseases (25 F, age 50 ± 15 years). METHODS: Each patient performed spirometry, CPF, PEmax, Cough Pgas and maximal inspiratory pressure (PImax). Normal values for each test were determined from published and in-house lab data. RESULTS: In all patients, vital capacity ranged from 46 to 119% of pred. Twenty seven percent of patients resulted under the lower normal limit of CPF and this percentage was significantly lower as compared to that of PEmax and Cough Pgas (51% and 53% respectively, P=0.013). Combining all three tests, the percentage of patients resulting below normal was 22% (P=0.638, as compared to CPF results alone). Additionally, CPF correlated significantly with PImax, PEmax, and Cough Pgas (P<0.01 for each correlation) and by multiple regression analysis PImax and PEmax contributed 65% of CPF variance. CONCLUSION: Our study shows that in neuromuscular patients, PEmax and Cough Pgas values may overdiagnose an ineffective cough. CPF, a non invasive and easy to perform test, is a global measure of voluntary cough. CLINICAL REHABILITATION SETTING:CPF may be relevant in the routine evaluation of patients with neuromuscular diseases, both in research and in rehabilitation settings.


Assuntos
Tosse/fisiopatologia , Doenças Neuromusculares/fisiopatologia , Pico do Fluxo Expiratório/fisiologia , Músculos Respiratórios/fisiopatologia , Capacidade Vital/fisiologia , Adulto , Tosse/etiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Neuromusculares/complicações , Doenças Neuromusculares/diagnóstico , Estudos Prospectivos
19.
Waste Manag ; 30(8-9): 1696-704, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20207128

RESUMO

The main objective of this paper is to investigate the properties of various concrete mixtures at fresh and hardened state, obtained by a partial substitution of coarse and fine aggregate with different volume percentages of waste tyres rubber particles, having the same dimensions of the replaced aggregate. Workability, unit weight, compressive and flexural strength and post-cracking behaviour were evaluated and a comparison of the results for the different rubcrete mixtures were proposed in order to define the better mix proportions in terms of mechanical properties of the rubberized concrete. Results showed in this paper were also compared to data reported in literature. Moreover, a preliminary geometrical, physical and mechanical characterization on scrap tyre rubber shreds was made. The rubberized concrete mixtures showed lower unit weight compared to plain concrete and good workability. The results of compressive and flexural tests indicated a larger reduction of mechanical properties of rubcrete when replacing coarse aggregate rather than fine aggregate. On the other hand, the post-cracking behaviour of rubberized concrete was positively affected by the substitution of coarse aggregate with rubber shreds, showing a good energy absorption and ductility indexes in the range observed for fibrous concrete, as suggested by standard (ASTM C1018-97, 1997).


Assuntos
Materiais de Construção , Borracha/química , Resíduos , Automóveis , Teste de Materiais , Fenômenos Mecânicos , Gerenciamento de Resíduos
20.
Waste Manag ; 29(6): 1960-70, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19167204

RESUMO

The increasing amount of waste tyres worldwide makes the disposition of tyres a relevant problem to be solved. In the last years over three million tons of waste tyres were generated in the EU states [ETRA, 2006. Tyre Technology International - Trends in Tyre Recycling. http://www.etra-eu.org]; most of them were disposed into landfills. Since the European Union Landfill Directive (EU Landfill, 1999) aims to significantly reduce the landfill disposal of waste tyres, the development of new markets for the tyres becomes fundamental. Recently some research has been devoted to the use of granulated rubber and steel fibres recovered from waste tyres in concrete. In particular, the concrete obtained by adding recycled steel fibres evidenced a satisfactory improvement of the fragile matrix, mostly in terms of toughness and post-cracking behaviour. As a consequence RSFRC (recycled steel fibres reinforced concrete) appears a promising candidate for both structural and non-structural applications. Within this context a research project was undertaken at the University of Salento (Italy) aiming to investigate the mechanical behaviour of concrete reinforced with RSF (recycled steel fibres) recovered from waste tyres by a mechanical process. In the present paper results obtained by the experimental work performed up to now are reported. In order to evaluate the concrete-fibres bond characteristics and to determine the critical fibre length, pull-out tests were initially carried out. Furthermore compressive strength of concrete was evaluated for different volume ratios of added RSF and flexural tests were performed to analyze the post-cracking behaviour of RSFRC. For comparison purposes, samples reinforced with industrial steel fibres (ISF) were also considered. Satisfactory results were obtained regarding the bond between recycled steel fibres and concrete; on the other hand compressive strength of concrete seems unaffected by the presence of fibres despite their irregular geometric properties. Finally, flexural tests furnished in some cases results comparable to those obtained when using ISF as concerns the post-cracking behaviour.


Assuntos
Conservação dos Recursos Naturais , Materiais de Construção , Aço , Resíduos , Força Compressiva , Veículos Automotores
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