A new predictive equation for evaluating women body fat percentage and obesity-related cardiovascular disease risk.

BACKGROUND: Obesity represents a global public health problem due to its association with cardiovascular diseases and reduced lifespan. The most widely used classification of obesity is expressed as Body Mass Index (BMI); however, this formula is an imprecise adiposity measurement that ignores several important factors involved. Body Adiposity Index (BAI) was more recently proposed as an indirect evaluation of percentage body fat (PBF). PBF is a direct measure of person's relative body fat and a better predictor of obesity-related risk diseases than BMI and BAI. Since obesity and consequent diseases are considered epidemic, new accurate formulas for epidemiological studies are of interest to the scientific community. Because direct measurement of body composition could be quite expensive, the aims of our work were to analyse the distributions of PBF by Dual X-ray absorptiometry, and the creation of new predictive equation using only anthropometric measures that could be helpful to clinicians to assess easily body fat of female patients. METHODS/RESULTS: A sample of 1,031 Caucasian Italian women was recruited and BMI, BAI and PBF were evaluated. With the aim of developing a predictive model of PBF a multivariate regression model was fitted to observed data. CONCLUSIONS: The definition of universally recognized PBF by gender and age could have public health implications. In this study, we developed a new predictive PBF equation that does not require the use of medical instruments or skilled measurement techniques and that may be easily applicable to Italian women.

Body composition phenotype: Italian Mediterranean Diet and C677T MTHFR gene polymorphism interaction.

OBJECTIVES: Strategies to improve weight maintenance are focused on considering the genetic makeup and its interaction with dietary intake, with the aim to identify vulnerable individuals that will benefit from a variety of more personalized dietary recommendations. The aim of the study was to examine the impact of the C677T MTHFR gene Polymorphism on body composition changes induced by a balanced hypocaloric Italian Mediterannean diet (IMD). SUBJECTS AND METHODS: Participation in the study included a complete screening of anthropometry and body composition by Dual-energy X-ray absorptiometry (DXA), and a genotyping for the C677T MTHFR polymorphism. 70 Italian Caucasian obese were enrolled and 56 of them completed the screening at baseline and 12 weeks after the nutritional intervention. RESULTS: T(+) carriers had a higher content of Total Body Fat (TBFat), and Lean (TBLean), reflecting on higher weight and BMI, than T(-) carriers. After IMD, the 28.6% and 71.4% of total subjects decreased weight and TBFat (Kg), respectively. The relative changes were: delta % = -9.09±3.85 for weight; delta % = -15.79±8.51 for TBFat; delta % = -3.80±5.60 for TBLean. The 5.3% of subjects who reached the end point of intervention, and the 8.9% who reduced TBFat (%) below the cut-off of preobesity, were T(-) carriers. A loss of TBLean (Kg) was observed in the 5.1% and 23.5% of T(-) and T(+) carriers. CONCLUSIONS: MTHFR genetic variations analysis would be an innovative tool for the nutritional assessment, in order to predict the therapeutic response of obese subjects, in terms of fat and lean mass loss.

Effects of dark chocolate in a population of normal weight obese women: a pilot study.

BACKGROUND: Normal weight obese (NWO) syndrome is defined as an excessive body fat associated with a normal body mass index and characterized by a higher risk for cardiovascular morbidity and mortality. Recent studies have demonstrated that dark chocolate (DC) has beneficial effects in the prevention of cardiovascular diseases (CVD) due to its anti-inflammatory and antioxidant properties. AIM: The aim of the present study was to investigate the effects of DC consumption on lipid profile, inflammatory markers, biochemical parameters, and blood pressure, in NWO women. MATERIALS AND METHODS: 15 women affected by NWO syndrome, aged 20-40 years, were included in the study. After a DC-free washout period, subjects received DC (100 g/die) containing 70% cocoa for 7-days. Body composition by Dual energy-X-ray absorptiometry (DXA) was performed at baseline. Blood pressure, anthropometric measurements, biochemical parameters and plasma levels of some cytokines were measured before and after DC consumption. RESULTS: After DC consumption, we observed a significant increase in the HDL cholesterol level (Delta% = +10.41±13,53; p ≤ 0.05), a significant decrease of total cholesterol/HDL cholesterol ratio (Delta %= -11.45±7.03; p ≤ 0.05), LDL/HDL cholesterol ratio (Delta % = -11.70±8.91; p ≤ 0.05), and interleukin-1 receptor antagonist (IL-1Ra) (Delta % = -32.99±3.84; p ≤ 0.05). In addition, a reduction in abdomen circumference was observed. We also found a positive correlation between changes in atherogenic indices, and IL-1Ra, abdomen reduction. CONCLUSIONS: Our findings suggest that regular consumption of DC could be useful in maintaining a good atherogenic profile, due to the favourable effects on HDL cholesterol, lipoprotein ratios and inflammation markers.

Tobacco smoking and MRI/MRS brain abnormalities compared to nonsmokers.

This mini review emphasizes the fact that tobacco smoking causes small but real biologic brain changes that need to be studied in depth. A crucial question is whether these anatomical/chemical changes reverse toward normal when smokers quit. This review is presented to stimulate further research to answer this question.

Allergic reactions to isosulfan blue during sentinel node biopsy--a common event.

BACKGROUND: Sentinel lymph node (SLN) dissection in the management of high-risk melanoma and other cancers, such as breast cancer, has recently increased in use. The procedure identifies an SLN by intradermal or intraparenchymal injection of an isosulfan blue dye, a radiocolloid, or both around the primary malignancy. METHODS: At the time of selective SLN mapping, 3 to 5 mL of isosulfan blue was injected either intradermally or intraparenchymally around the primary malignancy. From October 1997 to May 2000, 267 patients underwent intraoperative lymphatic mapping with the use of both isosulfan 1% blue dye and radiocolloid injection. Five cases with adverse reactions to isosulfan blue were reviewed. RESULTS: We report 2 cases of anaphylaxis and 3 cases of "blue hives" after injection with isosulfan blue of 267 patients who had intraoperative lymphatic mapping by the procedure described above. The 2 patients with anaphylaxis experienced cardiovascular collapse, erythema, perioral edema, urticaria, and uvular edema. The blue hives in 3 patients resolved and transformed to blue patches during the course of the procedures. CONCLUSIONS: The incidence of allergic reactions in our series was 2.0%. As physicians expand the role of SLN mapping, they should consider the use of histamine blockers as prophylaxis and have emergency treatment readily available to treat the life- threatening complication of anaphylactic reaction.

Nicotine and tobacco dependence: normalization or stimulation?

Nicotine and tobacco use produces mixed stimulant and depressant effects on various brain functions in animals and human beings. Results of electroencephalographic studies indicate that some tobacco smokers after 10-24 h of tobacco deprivation exhibit a decrease in dominant alpha rhythm, which, immediately after smoking, increases toward that of nonsmokers. This is evidence that tobacco smoking in smokers involves normalization of brain activity. Results of other studies of acute smoking effects in smokers show an increase in dominant alpha rhythm greater than that of nonsmokers. This is evidence that tobacco smoking produces stimulation of brain activity in smokers.

Regional cerebral blood flow effects of nicotine in overnight abstinent smokers.

BACKGROUND: Most people agree that dependence to tobacco is mediated by the effects of nicotine on the central nervous system, albeit the neural pathways involved are not clearly delineated. We investigated the effect of nasal nicotine spray on regional cerebral blood flow (rCBF) in a sample of habitual smokers, with H2 15O and positron emission tomography (PET). METHODS: Eighteen volunteer smokers were studied after 12 hours of smoking deprivation. Regional cerebral blood flow measures were obtained with PET and 50 mCi H2 15O in six consecutive scans. Nicotine spray and a placebo spray were administered in a single-blind design, preceded and followed by baseline studies. Images were coregistered and anatomically standardized. Square (9-mm side) regions of interest were placed in 10 preselected brain regions, bilaterally. The effects of the experimental condition and gender were tested with two-way repeated-measures analysis of variance in each of the regions studied. RESULTS: Nicotine reduced rCBF in the left anterior temporal cortex and in the right amygdala. Increases were noted in the right anterior thalamus. CONCLUSIONS: In habitual smokers after overnight abstinence, nicotine induced differing effects on regional blood flow relative to whole brain blood flow. Increases were observed in the thalamus, a region rich in nicotinic receptors, and reductions in limbic and paralimbic (amygdala, anterior temporal cortex) regions.

Nicotine induced behavioral locomotor sensitization.

1. Nicotine behavioral sensitization of locomotor activity was investigated in adult female Sprague Dawley rats. Five different experiments were performed with nicotine in various doses of 0.1, 0.32, or 1.0 mg/kg i.p. These included: 1) effects of daily nicotine for 6 days, 2) effects of once per week nicotine for 3 weeks, 3) effects of MK-801 on nicotine-induced locomotor activity, 4) effects of dexamethasone on nicotine-induced locomotor activity, 5) induction of tolerance to nicotine-induced locomotor sensitization and lack of cross tolerance to caffeine. 2. Locomotor activity was measured with a photoelectric computerized system. The first dose of nicotine (0.32 mg/kg) induced marked locomotor depression. Once daily injection of 0.32 mg/kg of nicotine for 6 days produced tolerance to its depressant effects and sensitized the rats to its stimulant effects. Three once weekly doses of 0.32 mg/kg of nicotine also produced tolerance to its depressant effects and some locomotor stimulation. 3. Daily pretreatment for 5 days with a dose of 0.18 mg/kg of MK-801 i.p. partially antagonized the locomotor depressant and stimulant actions of nicotine. 4. Dexamethasone (1 mg/kg i.p.) daily pretreatment barely reduced nicotine locomotor depression and only very slightly enhanced locomotor stimulation. 5. Accumulating doses of 0.32 and 1.0 mg/kg b.i.d. of nicotine produced tolerance to its locomotor stimulant effects in rats previously sensitized to 0.32 mg/kg. There was no cross-tolerance to 32 mg/kg of caffeine citrate in previously sensitized animals tolerant to the stimulant effects of nicotine.

Effects of nicotine on regional cerebral glucose metabolism in awake resting tobacco smokers.

Eleven healthy tobacco smoking adult male volunteers of mixed race were tobacco abstinent overnight for this study. In each subject, positron emission tomographic images of regional cerebral metabolism of glucose with [18F]fluorodeoxyglucose were obtained in two conditions in the morning on different days: about 3min after approximately 1-2mg of nasal nicotine spray and after an equivalent volume of an active placebo spray of oleoresin of pepper in a random counterbalanced design. A Siemens/CTI 931/08-12 scanner with the capability of 15 horizontal brain slices was used. The images were further converted into a standard uniform brain format in which the mean data of all 11 subjects were obtained. Images were analysed in stereotactic coordinates using pixel-wise t statistics and a smoothed Gaussian model. Peak plasma nicotine levels varied three-fold and the areas under the curve(0-30min) varied seven-fold among the individual subjects. Nicotine caused a small overall reduction in global cerebral metabolism of glucose but, when the data were normalized, several brain regions showed relative increases in activity. Cerebral structures specifically activated by nicotine (nicotine minus pepper, Z score >4.0) included: left inferior frontal gyrus, left posterior cingulate gyrus and right thalamus. The visual cortex, including the right and left cuneus and left lateral occipito-temporal gyrus fusiformis, also showed an increase in regional cerebral metabolism of glucose with Z scores >3. 6. Structures with a decrease in regional cerebral metabolism of glucose (pepper minus nicotine) were the left insula and right inferior occipital gyrus, with Z scores >3.5. Especially important is the fact that the thalamus is activated by nicotine. This is consistent with the high density of nicotinic cholinoceptors in that brain region. However, not all brain regions affected by nicotine are known to have many nicotinic cholinoceptors. The results are discussed in relation to the cognitive effects of nicotine.

Nicotine effects on regional cerebral blood flow in awake, resting tobacco smokers.

The hypothesis for this research was that regional cerebral blood flow (rCBF) would increase following nasal nicotine administration to overnight abstinent tobacco smokers in relationship to the known brain distribution of nicotinic cholinergic receptors (nAChRs). Nine male and nine female healthy adult smokers were studied. They abstained overnight from tobacco products for 10 or more hours prior to study the next morning. Nicotine nasal spray was given in doses of 1-2.5 mg total with half in each nostril while the subject was awake and resting in a supine position. Oleoresin of pepper solution in a similar volume was used as an active placebo to control for the irritating effects of nicotine. Both substances were given single blind to the subjects. Positron emission tomography (PET) with H(2)(15)O was used to measure rCBF. The data from each subject volunteer were normalized to global activity to better assess regional brain changes. Both nasal nicotine and pepper spray produced similar increases in CBF in somesthetic area II, consistent with the irritant effects of both substances. The mean rCBF effects of nasal pepper were subtracted from those of nasal nicotine to determine the actions of nicotine alone. The latter produced increases in rCBF in the thalamus, pons, Brodman area 17 of the visual cortex, and cerebellum. Some brain areas that contain a large number of nAChRs, such as the thalamus, showed an increase in CBF. Other areas that have few nAChRs, such as the cerebellum, also showed an increase in relative CBF. The hippocampal/parahippocampal areas showed greater regional decreases (left) and lesser increases (right) in CBF that correlated with the increase in plasma arterial nicotine concentrations. The results obtained indicate complex primary and secondary effects of nicotine in which only some regional brain CBF changes correlate with the known distribution of nAChR. No gender differences were noted.

Effects of tobacco smoking on topographic EEG and Stroop test in smoking deprived smokers.

1. Quantitative electroencephalography (EEG) was used to measure human brain electrical changes produced by tobacco deprivation and smoking. Sixteen scalp cortical recording sites monitored regional changes in brain activity. 2. The quantitative EEG was subdivided into delta, theta, alpha1, alpha2, beta1 and beta2 bands for topographic mapping. A demanding version of the Stroop test was used to determine tobacco smoking effects on attention. The version used was more difficult than that used in previously reported studies. 3. Healthy drug and substance free adult male and female volunteers were divided into nonsmoker (n=7) and smoker (n=7) groups according to their smoking status. They were instructed to abstain from tobacco products for at least 12 hr overnight before the next morning's experiment. 4. EEG was recorded before and after smoking either a fake placebo cigarette for nonsmokers or the cigarette of their choice for smokers. Subjects were also asked to perform the Stroop test before and after smoking the placebo or tobacco cigarette. 5. The results showed that tobacco smoking significantly depressed delta and increased alpha2 and beta1 activity and slightly increased the Stroop effect. Although smoking one cigarette stimulated brain electrical activity of smoking deprived smokers, it did not improve performance on a difficult Stroop test.

History of modern psychopharmacology: a personal view with an emphasis on antidepressants.

OBJECTIVE: This article provides the chemical basis for the molecular modification of H1 antihistamines in the rational development of some antidepressant and antipsychotic drugs. METHODS: A review of the literature and personal experiences have been compiled. CONCLUSIONS: The contributions of many basic scientists, the crucial observations of clinicians, and the desire of the drug industry to make money have resulted in the currently available psychopharmacological treatments. The future development of psychopharmacology depends on better clinical research to generate new hypotheses of the chemical and behavioral pathology of mental disease. Psychosomatic medicine can make a unique contribution in its interdisciplinary role of stressing brain, body, and mind relationships.

Nicotine alone and in combination with L-DOPA methyl ester or the D(2) agonist N-0923 in MPTP-induced chronic hemiparkinsonian monkeys.

Nicotine, the soluble methyl ester of L-DOPA, and the D(2) agonist N-0923 were given alone and in combination im to five hemiparkinsonian monkeys. Daily nicotine in doses of 32-320 micrograms/kg for 6 days each, surprisingly, had slight effects on motor activity. When combined with N-0923, nicotine did not further enhance its effects. However, L-DOPA methyl ester plus nicotine produced greater contraversive circling than L-DOPA methyl ester plus 0.9% NaCl. Similar effects were obtained on significant motor movements of both the affected (contralateral) and normal (ipsilateral) arm and hand. The results indicate that nicotine is synergistic with l-DOPA methyl ester, but not with the postsynaptic D(2) agonist N-0923.

A further study on asymmetric cross-sensitization between MK-801 and phencyclidine-induced ambulatory activity.

Our previous study found that MK-801-sensitized rats showed cross-sensitization to the locomotor stimulant effects of phencyclidine, but phencyclidine sensitized rats did not show cross-sensitizaton to MK-801. This study was designed to determine whether the asymmetric cross-sensitization was due to injection-environment conditioning or possibly reduced phencyclidine-like effects following further repeated injections of phencyclidine. Adult female Sprague-Dawley rats were used in this study, and their activity was assessed with an automated photoelectric system. Results confirmed the early finding that four daily injections of phencyclidine (3.2 mg/kg) or MK-801 (0.32 mg/kg) produced locomotor sensitization, and that the two drugs showed asymmetric cross-sensitization. Moreover, injection-environment conditioning was ruled out as a possible cause for cross-sensitization from MK-801 to phencyclidine, and possibly reduced phencyclidine-like effects following further repeated injections was also ruled out as a cause for the failure of cross-sensitization from phencyclidine to MK-801. These additional results further confirm our previous finding, and indicate that there are significant differences in the neural mechanisms underlying phencyclidine- and MK-801-induced sensitization.

Effects of tobacco smoking on the human pupil.

OBJECTIVE: Determine the effects of tobacco cigarette or sham placebo-smoking on pupil diameter. SUBJECTS: Ten non-smokers and 10 tobacco smokers (all healthy, drug free adults) were studied while resting in a comfortable lounger. METHODS: Tobacco smokers abstained from smoking and all subjects abstained from caffeine-containing products for at least 8 h prior to testing. The smokers each smoked one tobacco cigarette, and the non-smokers each inhaled air through an unlit sham cigarette. Right pupil diameter, heart rate, systolic and diastolic blood pressure were measured before and after sham- or tobacco-smoking in each subject. Pupil size was measured from a colored photograph taken with a Polaroid camera equipped with a high-speed flash with the subject in a standardized, dimly lit quiet room. RESULTS: There was no significant difference in baseline pupil diameter between non-smokers and smokers prior to sham- or tobacco-smoking. After sham- or tobacco-smoking, both non-smokers and smokers showed slight but statistically significant pupillary constriction. CONCLUSIONS: Shortly after smoking one tobacco cigarette, pupillary constriction was greater than after sham-smoking.

Arterial/venous plasma nicotine concentrations following nicotine nasal spray.

BACKGROUND AND OBJECTIVES: Arterial (A) and venous (V) plasma nicotine and cotinine concentrations were measured after nasal nicotine spray in tobacco smokers of both genders. The hypothesis for this research was that a greater A/V difference in plasma nicotine would be present in males than females because males have greater skeletal muscle mass to bind nicotine. SUBJECTS AND METHODS: Nine male and nine female healthy adult smokers were studied. They all abstained from use of tobacco overnight for 10 h or more prior to the study. Nicotine nasal spray was given in doses of 1-2.5 mg total, with half in each nostril while the subject was supine. Both A and V blood samples were obtained prior to and 3, 6, 10, 15, 20, and 30 min post-nasal nicotine spray. RESULTS AND CONCLUSIONS: Nasal nicotine administration produced greater A than V plasma levels. There were no gender differences in A/V nicotine concentrations, disproving the above hypothesis, suggesting that other physiochemical factors besides skeletal muscle mass must be involved. Heart rate increases correlated well with arterial plasma nicotine levels (r = 0.77). Males had less variance than females in the expected increase in arterial plasma nicotine concentrations with increased number of nasal sprays. Although there was considerable overlap, mean A cotinine concentrations were consistently slightly larger than V concentrations.

Effects of pramipexole on contraversive rotation and functional motor impairments in 1-methyl-4-phenyl1,2,3, 6-tetrahydropyridine-induced chronic hemiparkinsonian monkeys.

Rotational and functional motor behavioral changes were studied in five MPTP lesioned chronic hemiparkinsonian Macaca nemestrina monkeys after i.m. pramipexole, a predominant D2 subfamily agonist. Pramipexole induced contraversive rotations in a dose-dependent manner with an optimal dose of 56 microg/kg for approximately 2 to 4 hr after injection. Three different rating scales were used to determine drug-induced functional improvement. They included a monkey parkinsonism rating scale, volitional responses to fruit presentations, and number of hand movements that appeared volitional. A dose of 56 microg/kg of pramipexole produced functional improvements on hand disability, and on a parkinsonian rating scale for monkeys in a dose-dependent manner from 32 to 100 microg/kg. These doses produced an increase in significant hand movements in the affected (contralateral) as well as in the normal (ipsilateral) hand to the side of the brain lesion compared with 5% dextrose in water vehicle control. With a dose of 100 microg/kg, the therapeutic effects of pramipexole on hand movements were less than with 56 microg/kg, due to side effects such as scratching.