Adolescent Vulnerability to Heightened Emotional Reactivity and Anxiety After Brief Exposure to an Obesogenic Diet.

BACKGROUND: Emerging evidence demonstrates that diet-induced obesity disrupts corticolimbic circuits underlying emotional regulation. Studies directed at understanding how obesity alters brain and behavior are easily confounded by a myriad of complications related to obesity. This study investigated the early neurobiological stress response triggered by an obesogenic diet. Furthermore, this study directly determined the combined impact of a short-term obesogenic diet and adolescence on critical behavioral and molecular substrates implicated in emotion regulation and stress. METHODS: Adolescent (postnatal day 31) or adult (postnatal day 81) Lewis rats were fed for 1 week with an experimental Western-like high-saturated fat diet (WD, 41% kcal from fat) or a matched control diet (CD, 13% kcal from fat). We used the acoustic fear-potentiated startle (FPS) paradigm to determine the effects of the WD on cued fear conditioning and fear extinction. We used c-Fos mapping to determine the functional influence of the diet and stress on corticolimbic circuits. RESULTS: We report that 1-week WD consumption was sufficient to induce fear extinction deficits in adolescent rats, but not in adult rats. We identify fear-induced alterations in corticolimbic neuronal activation and demonstrate increased prefrontal cortex CRHR1 messenger RNA (mRNA) levels in the rats that consumed the WD. CONCLUSION: Our findings demonstrate that short-term consumption of an obesogenic diet during adolescence heightens behavioral and molecular vulnerabilities associated with risk for anxiety and stress-related disorders. Given that fear extinction promotes resilience and that fear extinction principles are the foundation of psychological treatments for posttraumatic stress disorder (PTSD), understanding how obesogenic environments interact with the adolescent period to affect the acquisition and expression of fear extinction memories is of tremendous clinical relevance.

Effectiveness of long-term treatment with pantethine in patients with dyslipidemia.

A one-year clinical trial with pantethine was conducted in 24 patients with established dyslipidemia of Fredrickson's types II A, II B, and IV, alone or associated with diabetes mellitus. The treatment was well tolerated by all patients with no subjective complaints or detectable side effects. Blood lipid assays repeated after 1, 3, 6, 9, and 12 months of treatment revealed consistent and statistically significant reductions of all atherogenic lipid fractions (total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B) with parallel increases of high-density lipoprotein cholesterol and apolipoprotein A. The results were equally good in patients with uncomplicated dyslipidemia and in those with associated diabetes mellitus. The authors conclude that pantethine (a drug entity related to the natural compound, pantetheine) represents a valid therapeutic support for patients with dyslipidemia not amenable to satisfactory correction of blood lipids by diet alone.

Dietary treatment of dyslipidaemias.

Detailed and personalized dietary guidance must be given to subjects recognized as dyslipidaemic and to the parents of high-risk individuals. The diets should be hypolisocaloric with reduced intake of fats (30%) and cholesterol (250-300 mg/day) and with high intake of carbohydrate (55-60%), preferably complex. Dietary fibre intake should be at least 25 g/day.

Lipoprotein(a) and exercise.

Plasma levels of lipoprotein(a), total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, apoprotein A1 and apoprotein B were assessed in 10 healthy, untrained volunteers subjected to a bicycle ergometric exercise equal to 50% of individual VO2max, followed by increasing loads until muscular exhaustion. Blood samples were taken before the exercise, immediately afterwards and then at 12-hourly intervals for a 72 hours period. Subsequently, the same parameters were evaluated for 8 long-distance runners during the XXIII New York Marathon, with blood samples being taken before and after the race, and then after one month of detraining. After the exercise, lipoprotein(a) in untrained subjects began to decrease significantly from the 24th hour on and remained lower than baseline levels up till the 72nd hour. After detraining, lipoprotein(a) in marathon runners increased significantly both with respect to basal values and especially to post-race values. Modifications of the other metabolic parameters evaluated in both tests were negligible and predictable. In the two groups of subjects examined, no correlation was found between lipoprotein (a) and the anthropometrical data and metabolic parameters considered.

[Efficacy of blood lipid normalization and tolerance in dyslipidemic patients treated for 18 months with fibric acid derivatives]. / Efficacia normolipemizzante e tollerabilità in dislipidemici trattati per 18 mesi con derivati dell'acido fibrico.

Three groups of hyperlipoproteinemia patients have been submitted to long term treatment (18 months) with bezafibrate, gemfibrate and fenofibrate evaluating efficacy and tolerability of the three drugs. A global improvement of lipemic profile with an increase in protective (HDL, APO-A1) and a reduction in atherogenic factors (TC, LDL, APO-B, TG) has been shown, particularly at the end of the 18 months of therapy. No pathological changes have been observed in SGOT, SGPT, GGT values. Echotomography of biliary tract excluded the development of gallstones during treatment. The Authors can conclude with a positive judgement about use of these drugs in long term treatment of primary hyperlipoproteinemias, resistant to diet alone.

[Clinical experience on a new substance with high fibre content (author's transl)]. / Esperienze cliniche su un nuovo preparato ad elevato contenuto in fibre.

After a brief reference on the so-called diseases of "civilisation" and on their correlations with a diet rich in refined high caloric carbohydrate having poor gastric filling capacity and therefore lacking in fibre, the authors present their experience on a new product, MF/D/80, which is an association of cereal and acid fruit fibres. 25 patients (3 men and 22 women) were treated, 22 of them suffered from chronic constipation and 3 from colitis. The experiment was carried out without the use of control drugs. The aim of the research was that of verifying the efficacy and tolerability of the product. The efficacy was optimal in 88%, good in 4% and modest in 2 cases (8%) of the entire number of cases while the tolerability has been optimal in all the cases. The Authors conclude the retaining that MF/D/80 is a product that can be used with enormous advantages in chronic constipation for its efficacy, optimal tolerability and for its mechanism of action. The Authors finally underline its usefullness as an "alimentary integrator" in all those diseases (obesity, diabetes, atherosclerosis etc.) which among the various etiopathogenetic moments, also count in refined alimentation.

[Lp(a) and the cardiovascular risk in dyslipidemia subjects]. / Lp(a) e rischio cardiovascolare in soggetti dislipidemici.

In this paper the presence of a correlation between plasma Lp(a) levels and peripheral vascular disease (PVD) and/or coronary heart disease (CHD) was investigated in 20 dyslipidaemic patients (10 males and 10 females, well matched for age, type of hyperlydaemia and other CVD risk factors). Lp(a) plasma levels, ECG and carotid and femoral arteries duplex ultrasonography were performed in all the patients. No difference in plasma Lp(a) levels between patients without and with carotid and femoral arteries stenotic lesions was observed. On the contrary Lp(a) was significantly higher in patients with ECG signs of coronary ischaemic heart diseases than in patients with normal ECG. These observations confirm the importance of Lp(a) as a risk factor for coronary heart disease in dyslipidaemic patients.

[Retrospective study on 778 patients with acute myocardial infarct: relation between sex, age and blood lipid picture]. / Indagine retrospettiva su 778 pazienti con infarto miocardico acuto: rapporti tra sesso, età e quadro lipemico.

To evaluate the relationship between myocardial infarction and serum lipid levels, 778 patients admitted to the Fidenza Coronary Unit were studied. These patients were divided by sex and into groups by age decade and the frequency of hyperlipidemia was investigated. In the first place the association between myocardial infarction (MI) with hypercholesterolemia, second with hypertriglyceridemias was considered. In addition the population was subdivided in respect to the 3 more frequent types of hyperlipidemia (hypercholesterolemia, hypercholesterolemia and hypertriglyceridemia, hypertriglyceridemia). The results show the presence at a positive correlation between MI and hypercholesterolemia in the younger groups in both sexes, but mainly in female. Similar results are obtained when the correlation between MI and hypertriglyceridemia was considered, but at a lower statistical significance. The statistical analysis of the different types of hyperlipidemia confines the important pathogenetic role of hypercholesterolemia by itself and in association with hypertriglyceridemia. On the other hand hypertriglyceridemia does not show any primary influence on MI, but it acts synergistically with hypercholesterolemia. The strong association of hyperlipidemia and MI in the younger group and in female, documented in this study, confirms the importance of hypercholesterolemia and hypertriglyceridemia as a risk factor in the early development of coronary heart disease.

[Clinical use of pantethine by parenteral route in the treatment of hyperlipidemia]. / Impiego clinico della pantetina per via parenterale nella terapia delle dislipidemie.

Recent investigations have confirmed the effectiveness and the excellent tolerability of pantethine, a derivative of pantetheine, an essential part of the acetylation coenzyme CoA, administered P.O., in normalizing the blood lipid concentrations of patients with hyperlipidemias. A group of 18 patients with hyperlipidemias (9 M, 9 F), with an average age of 52.6 years, was submitted to pantethine parenteral treatment. After a 20 days wash-out, pantethine (400 mg/day; BID) was administered intramuscularly, for 20 days. Total cholesterol, triglycerides, HDL-cholesterol, apo A-1 and B lipoprotein, uric acid in serum, glycemia, CBC, B.U.N., creatininemia, E.S.R., SGOT, SGPT, bilirubinemia, cardiac frequency, blood pressure and body weight were controlled before and after treatment. The drug showed to have a therapeutic effectiveness by a rapid and significant improvement in the blood lipid pattern with reduction of total cholesterol, triglycerides and apo-B lipoprotein and increase of HDL-cholesterol and apo A-1 lipoprotein. The tolerability of pantethine at the stated dosage and mode of administration was invariably excellent, with non complaints or visible side effects imputable to the test drug. BUN, creatininemia, glycemia, SGOT, SGPT, bilirubinemia, E.S.R., CBC, cardiac frequency and blood pressure readings showed no noteworthy changes throughout the study.

Vitreous fluorophotometry and changes in blood-retinal barrier permeability induced by bendazac lysine.

Vitreous fluorophotometry was used to investigate the effect of Bendazac lysine on the blood retinal barrier in 12 insulin-dependent diabetics with mild background retinopathy. The study was a randomized, double blind, cross-over trial, drug versus Placebo. Each treatment period was of 4 months. The vitreous penetration coefficient was reduced by 21% (95% c.i. 12, 30; p = 0.001) by treatment with respect to Placebo.

Effectiveness of an uninterrupted procedure to transfer adolescents with Type 1 diabetes from the Paediatric to the Adult Clinic held in the same hospital: eight-year experience with the Parma protocol.

This paper reports an 8-yr retrospective study on the effects of an uninterrupted procedure of transition of 73 adolescents with Type 1 diabetes from the Paediatric to the Adult Clinic held in the same hospital. Interviewed patients had a mean age of 21.0+/-0.95 yr at transition. Patients were satisfied with the information received before transition (100%), and appreciated being introduced to the adult physician prior to being transferred (92%), and having found their paediatrician during the first visit at the Adult Clinic (100%). Consensus for transition was attained after 2-4 consultations in 66.6% of patients. Seventy-nine percent of patients considered 20 yr of age as an appropriate age to be transferred. Patients confirmed to have found at the Adult Clinic: privacy (85%), confidentiality (95%), short waiting times (78%), informal atmosphere (100%), and the same consultant (100%). Only 3% of patients tried to go back to the Paediatric Clinic but they were discouraged. Clinic attendance rate ranged between 92 and 100%. We consider that the key factors for a successful process of transition from a Paediatric to an Adult Clinic are: age at transfer around 20 yr, smooth movement within the same hospital, consensus of patients and their parents, prior personal contact with the adult physician, paediatrician attendance at the first visit at the adult service and his unambiguous role against all attempts to go back to the paediatric service and, finally, the availability of the same physician at out-patient clinic visits.

[Serial determination of HbA1 or the oral glucose test in the adequate evaluation of fetal growth?]. / Dosaggi seriati di HbA1 o test orale di tolleranza glucidica per una adeguata valutazione della crescita fetale?

The authors compared sequential HbA1 levels with the results obtained by oral glucose tolerance test (O.G.T.T.) with the purpose of detecting the confidence limit of each test regarding the glucose control in pregnant women. HbA1 detection showed more sensitivity than O.G.T.T. in detecting maternal impaired glucose control and in distinguishing between a metabolic or a genetic feto-neonatal macrosomia.

[Hyperlipidemia, diabetes and atherosclerosis: efficacy of treatment with pantethine]. / Iperlipidemia, diabete ed aterosclerosi: efficacia del trattamento con pantetina.

The hypolipidemizing effects of Pantethine were investigated by the Authors in 37 hypercholesterolemic and/or hypertriglyceridemic patients. Of these, 21 were also diabetic, in a satisfying glucidic compensation, in order to verify the action of this drug also in this metabolic condition. The study was carried out for three months and during this period the patients were given Pantethine at the dose of 600 mg/die orally. At the 30th, the 60th, the 90th day of treatment the following parameters were controlled: cholesterolemia, HDL cholesterol, apolipoproteins A and B, triglyceridemia, systolic and diastolic arterial pressure, uricemia, body weight. Thirty days after suspending the treatment, the parameters were controlled again to detect a possible "rebound" effect. The results were analyzed on the whole case-record, subdividing the patients in dislipidemic and diabetic-dislipidemic, and on the basis of the Fredrickson's classification. Pantethine induced in all groups a quick and progressive decrease of cholesterolemia, triglyceridemia, LDL cholesterol and Apolipoproteins B with increased HDL cholesterol and Apolipoproteins A. After suspending the treatment, there is a clear inversion of the state of these parameters. The Authors conclude that the present work shows that Pantethine, a natural and atoxic substance, an important component of Coenzyme A, is efficacious in determining a clear tendency towards normalization of the lipidic values.

[Dietary fiber and OGTT: blood sugar variations after administration of a new purified glucomannane]. / Fibre dietetiche ed OGTT: variazioni glicemiche dopo somministrazione di un nuovo glucomannano purificato.

After having stressed the importance of fibres in the nutritional field, pointing out the inverse relationship between vegetal fibres consumption in various populations and diffusion of many diseases of the so-called "industrialized" societies (such as obesity, diabetes, dyslipidemias, atherosclerosis, cholelithiasis, cancer of the colon, etc.), the Authors report their experiment on a new experimental product based on glucomannane purified (PRL). The present study was carried out on 24 obese subjects (5 males and 19 females). The patients, normoglycemics in their basic condition, were submitted to OGTT with 75 g of glucose in the morning before eating and were subdivided into two groups, the first (Group A) characterized by the sequence OGTT + placebo; after a few days, by another OGTT + experimental product; the second characterized by the inverse sequence. Four tablets (glucomannane purified 5,2 g) and four tablets of placebo was the posology employed. The evaluation of the possible action of the product in reducing or slowing down the intestinal absorption of glucose was the aim of the research. The results obtained show that the administration of the product under study has led to a sharp decrease of the average glycemic values with variations per cent ranging from 13% to 16% in Group A, from 10% to 11% in Group B and from 7% to 12% in the two groups considered on the whole. In conclusion, the Authors wish an increased diffusion of dietary fibres and particularly of the glucomannanes in all those dysmetabolic forms having at their bases an unbalanced, hypercaloric alimentation, rich in refined aliments and poor in fibres.

[Clinical study of the use of a deproteinized guar flour in the treatment of obesity]. / Ricerca clinica sull'impiego di una farina deproteinizzata di guar nel trattamento dell'obesità.

The Authors have studied an experimental product (L. G. 140/S), based on GUAR GUM, to establish its effectiveness and tolerability as a dietetic support in the treatment of obesity. The clinical research work has been conducted on 21 obese subjects (18 females and 3 males) aged 17 to 58 and treated with a hypocaloric and hypoglycemic diet. This preparation has proved useful in helping the patients to conform to the dietary restrictions and/or in normalizing their intestinal transit. No objective or subjective symptoms certainly referable to this preparation have been observed. The administration of the product has been interrupted for precautionary reasons in some cases, since it was not indispensable. Considering the good results they have obtained in terms of tolerability and agreeableness of this product, the Authors conclude that it can be considered a useful support to the restrictive dietary regimen, which is still considered - together with physical activity - the only sound and effective remedy in the treatment of obesity.

[Clinical study of a new preparation from plantago seeds and senna pods]. / Studio clinico su un nuovo preparato di semi di piantaggine e frutti di senna.

The lack of fiber in the western diet may contribute to the development of several diseases including gastrointestinal disorders; the clinical effects of a new substance (AGIOLAX) made from plantago seeds and senna pods were studied. 100 patients of both sexes, aged from 40 to 60 years (30 with diabetes mellitus, 40 with obesity and 30 with hyperlipidemia) were treated; everyone complained a slowness, of different degree, of normal intestinal transit time or chronic constipation. The experiment was carried out without the use of a control group. Aim of the present study was to investigate the efficacy and tolerability of the product. In addition to the clinical evaluation of the symptoms, laboratory tests were performed. The patients were treated for 3 months with a daily dose of 2 teaspoons every evening. In the majority of the subjects a good clinical response was obtained; 88% of the patients presented a normalization of the gastrointestinal transit time; only 12% of them did not respond satisfactorily to the substance. Further the drug was well tolerated by 86% of the patients. In conclusion the authors report a good efficacy and tolerability of the product; thus they recommend its use in those disorders characterized by slow intestinal transit time and/or constipation.

Effect of iodine administration on thyroid function in diabetic patients.

Iodide-induced hypothyroidism has been observed in subjects treated with compounds with mild antithyroid activity. The hypoglycemic agent tolbutamide belongs to the aminoheterocyclic group, a class of compounds with antithyroid effect. Thus it was thought interesting to study the effect of large doses of iodide on thyroid function in diabetics chronically treated with tolbutamide. Basal thyroid function as assessed by clinical examination and iodothyronine and TSH concentrations was normal in all patients. Furthermore, in diabetics treated with tolbutamide, hormone concentrations were not different from those of patients treated with insulin or diet. Serum T4, T3 and TSH did not show any significant variation throughout the investigation period. Our results suggest that thyroid function is not affected by chronic treatment with tolbutamide even when large doses of iodide are administered.

[Etiopathogenetic role of metabolic, circulatory, sex factors and type and duration of diabetes in diabetic retinopathy. Investigation with vitreofluorophotometry]. / Ruolo eziopatogenetico di fattori metabolici, emovascolari, sesso, tipo e durata del diabete nella retinopatia diabetica. Indagine compiuta con la vitreofluorofotometria.

We have studied metabolic, circulatory and vascular parameters in a group of 57 diabetics (37 affected by IDDM, 20 affected by NIDDM; 35 were males, 22 were females). Goals of present study were: 1) quantitative evaluation of the blood retinal barrier; 2) influence of the metabolic state, blood pressure, sex, type and duration of the diabetes on the ocular conditions; 3) relationship between ophthalmoscopic appearance of the retina and vitreous fluorophotometric recordings. We concluded that: a) ocular alterations depend by lipidic metabolism, blood pressure, sex, type and duration of the diabetes; b) vitreous fluorophotometry has proved a good device for early detection of retinal damages in the diabetic retinopathy.