Understanding the effects of air pollution on neurogenesis and gliogenesis in the growing and adult brain

Exposure to air pollution - and particularly to particulate matter (PM) - is strongly associated with higher risk of neurodevelopmental disorders, poor mental health and cognitive defects. In animal models, disruption of CNS development and disturbances of adult neurogenesis contribute to PM neurotoxicity. Recent studies show that gestational PM exposure not only affects embryonic neurodevelopment, but also disturbs postnatal brain growth and maturation, by interfering with neurogenic/gliogenic events, myelination and synaptogenesis. Similarly, adult neurogenesis is affected at many levels, from neural stem cell amplification up to the maturation and integration of novel neurons in the adult brain parenchyma. The underlying mechanisms are still by and large unknown. Beyond microglia activation and neuroinflammation, recent studies propose a role for novel epigenetic mechanisms, including DNA methylation and extracellular vesicles-associated microRNAs

Effects of a 3-Week In-Hospital Body Weight Reduction Program on Cardiovascular Risk Factors, Muscle Performance, and Fatigue : A Retrospective Study in a Population of Obese Adults with or without Metabolic Syndrome

Background: In clinical practice, there is the diffuse conviction that obese subjects with metabolic syndrome may be more difficult to treat. Objectives and methods: The aim of the present study was that to investigate the effectiveness of a 3-week in-hospital body weight reduction program (BWRP) in a large population of obese subjects with and without metabolic syndrome (n = 1922; 222 men and 1700 women, age range 18-83 yr). Outcomes such as body mass index (BMI), total (TOT) and HDL cholesterol, systolic and diastolic blood pressures (SBP and DBP, respectively), coronary heart disease (CHD) score, fatigue severity score (FSS), and stair climbing test (SCT) time were evaluated before and after the intervention (\u394). A sex-, BMI-, and age-related stratification of the obese population with or without metabolic syndrome was applied. Results: When compared to obese subjects without metabolic syndrome, at the basal conditions, obese subjects had a poorer cardiometabolic profile, as demonstrated by higher triglycerides, TOT-cholesterol, DBP, SBP, and CHD score, and a more compromised muscle performance (evaluated by SCT), associated with more perception of fatigue (measured by FSS). Nevertheless, obese subjects with metabolic syndrome obtained more benefits from BWRP than those without metabolic syndrome for some outcomes (i.e., \u394TOT-cholesterol, \u394SBP, and \u394CHD score). Despite these differences, the BWRP-induced weight loss was similar between the two groups (i.e., \u394BMI) as well as the gain of muscle performance (i.e., \u394SCT) and the reduction of fatigue (i.e., \u394FSS). Interestingly, the potentially deleterious fall in HDL-cholesterol levels after BWRP was less evident in obese subjects with metabolic syndrome than those without metabolic syndrome. When pooling all data, the \u394CHD score was associated with age, sex, and metabolic syndrome. The remaining outcomes, such as \u394BMI, \u394FSS, and \u394SCT time, were associated with sex and age but not with metabolic syndrome. Finally, \u394BMI was positively correlated with \u394CHD score, \u394FSS, and \u394SCT time in both obese subjects without metabolic syndrome and obese subjects with metabolic syndrome. Conclusions: When comparing obese subjects undergoing a BWRP, metabolic syndrome is not a negative predictive factor affecting the effectiveness of this intervention in terms of weight loss, muscle performance, and psychological well-being

The Appetite-Suppressant and GLP-1-Stimulating Effects of Whey Proteins in Obese Subjects are Associated with Increased Circulating Levels of Specific Amino Acids

The satiating effect of whey proteins depends upon their unique amino acid composition because there is no difference when comparing whey proteins or a mix of amino acids mimicking the amino acid composition of whey proteins. The specific amino acids underlying the satiating effect of whey proteins have not been investigated to date. Aims and Methods. The aim of the present study was to evaluate the appetite-suppressant effect of an isocaloric drink containing whey proteins or maltodextrins on appetite (satiety/hunger measured by a visual analogue scale or VAS), anorexigenic gastrointestinal peptides (circulating levels of glucagon-like peptide 1 (GLP-1) and peptide tyrosine tyrosine (PYY)) and amino acids (circulating levels of single, total [TAA] and branched-chain amino acids [BCAA]) in a cohort of obese female subjects (n = 8; age: 18.4 \ub1 3.1 years; body mass index, BMI: 39.2 \ub1 4.6 kg/m2). Results. Each drink significantly increased satiety and decreased hunger, the effects being more evident with whey proteins than maltodextrins. Similarly, circulating levels of GLP-1, PYY and amino acids (TAA, BCAA and alanine, arginine, asparagine, citrulline, glutamine, hydroxyproline, isoleucine, histidine, leucine, lysine, methionine, ornithine, phenylalanine, proline, serine, threonine, tyrosine, and valine) were significantly higher with whey proteins than maltodextrins. In subjects administered whey proteins (but not maltodextrins), isoleucine, leucine, lysine, methionine, phenylalanine, proline, tyrosine, and valine were significantly correlated with hunger (negatively), satiety, and GLP-1 (positively). Conclusions. Eight specific amino acids (isoleucine, leucine, lysine, methionine, phenylalanine, proline, tyrosine, and valine) were implicated in the appetite-suppressant and GLP-1-stimulating effects of whey proteins, which may be mediated by their binding with nutrient-sensing receptors expressed by L cells within the gastrointestinal wall. The long-term satiating effect of whey proteins and the effectiveness of a supplementation with these amino acids (i.e., as a nutraceutical intervention) administered during body weight reduction programs need to be further investigated

Growth hormone-releasing effects of whole body vibration alone or combined with squatting plus external load in severely obese female subjects

Background: Whole body vibration (WBV) has been reported to exert growth hormone(GH)-releasing effects in healthy subjects. Despite the potential of WBV to positively affect body composition changes via lipolytic effects, few studies have been performed in obese subjects to date. Methods: This study evaluated the acute effects of WBV alone or in combination with squatting plus external load (WBV+S) on serum GH levels and blood lactate concentrations in 7 severely obese women (age 22 \ub1 5 years; BMI 39.9 \ub1 2.9 kg/m2). Results: WBV and WBV+S determined a significant GH increase (mean GH peaks 5.1 \ub1 1.9 ng/ml, p < 0.001 vs. basal, and 6.5 \ub1 3.7 ng/ml, p < 0.001 vs. basal, respectively), GH peaks occurring immediately after both exercise sessions. No significant differences were observed between GH peaks and GH net incremental area under the curve (nAUC) after both conditions (p = 0.39 and p = 0.53, respectively), the whole pattern of GH responsiveness being comparable among all the subjects. Lactate concentrations increased after both conditions (mean lactate peaks 2.0 \ub1 0.5 mmol/l, p < 0.05 vs. basal, and 4.5 \ub1 2.0 mmol/l, p < 0.001 vs. basal, respectively). The lactate response was significantly higher after WBV+S than after WBV (p < 0.05). Baseline GH and GH peak values positively correlated to baseline lactate and lactate peak concentrations in both conditions (R2 = 0.64, p < 0.001, and R2 = 0.52, p < 0.05, respectively). Conclusions: WBV alone stimulates GH release and lactate production in severely obese female subjects, with no additive effect when combined with squatting plus external load. Further additional studies are required to verify the chronic effects of WBV exercise on the GH/IGF-1 system, which could represent a potentially effective approach for weight management in obese subjects

Whey Proteins Reduce Appetite, Stimulate Anorexigenic Gastrointestinal Peptides and Improve Glucometabolic Homeostasis in Young Obese Women

Introduction: Proteins, particularly whey proteins, represent the most satiating macronutrient in animals and humans. A dietetic regimen based on proteins enriched preload before eating might be a strategy to counteract obesity. Aims and Methods: The aim of the present study was to evaluate the effects of an isocaloric drink containing whey proteins or maltodextrins (preload) on appetite (satiety/hunger measured by a visual analogue scale or VAS), glucometabolic control (blood glucose/insulin), and anorexigenic gastrointestinal peptides (pancreatic polypeptide or PP, glucagon-like peptide 1 or GLP-1 and peptide YY or PYY) in a cohort of obese young women (n = 9; age: 18.1 \ub1 3.0 years; body mass index, BMI: 38.8 \ub1 4.5 kg/m 2 ). After two and a half hours, they were administered with a mixed meal at a fixed dose; satiety and hunger were measured by VAS. Results: Each drink significantly augmented satiety and reduced hunger, and the effects were more evident with whey proteins than maltodextrins. Similarly, there were significant increases in GLP-1 and PYY levels (but not PP) after the ingestion of each drink; these anorexigenic responses were higher with whey proteins than maltodextrins. While insulinemia identically increased after each drink, whey proteins induced a lower glycemic response than maltodextrins. No differences in satiety and hunger were found after the meal, which is presumably due to the late administration of the meal test, when the hypophagic effect of whey proteins was disappearing. Conclusions: While whey proteins actually reduce appetite, stimulate anorexigenic gastrointestinal peptides, and improve glucometabolic homeostasis in young obese women, further additional studies are mandatory to demonstrate their hypophagic effects in obese subjects, when administered as preload before eating

Multidisciplinary Integrated Metabolic Rehabilitation in Elderly Obese Patients: Effects on Cardiovascular Risk Factors, Fatigue and Muscle Performance

BACKGROUND: Obesity is a widespread problem in the elderly, being associated with severe comorbidities negatively influencing life expectancy. Integrated multidisciplinary metabolic rehabilitation aimed to reduce body weight (BW) and fatigue, increase physical autonomy and introduce healthy life style changes has been proposed as a useful intervention to improve the general health status and quality of life of the obese geriatric population. METHODS: Six hundred-eighty four severely obese subjects (F/M = 592/92; age range: 61-83 years; mean body mass index, BMI \ub1 SD: 42.6 \ub1 5.6 kg/m2) were admitted to take part in a three-week in-hospital BW reduction program (BWRP), entailing energy restricted diet, psychological counselling, physical rehabilitation and nutritional education. Biochemical parameters, cardiovascular risk factors (throughout the Coronary Heart Disease Risk, CHD-R), fatigue (throughout the Fatigue Severity Scale, FSS) and lower limb muscle performance (throughout the Stair Climbing Test, SCT) were evaluated before and at the end of the BWRP. RESULTS: A 4% BW reduction was achieved at the end of the BWRP. This finding was associated with a significant improvement of the metabolic homeostasis (i.e., decrease in total cholesterol and glucose) and a reduction of systolic blood pressure in both females and males, thus resulting in a reduction of CHD-R in the male group. Total FSS score and SCT time decreased in female and male obese patients. The effects of BWPR were comparable among all age-related subgroups (&gt;60, 60-69 and &gt;70 years), apart from \u394CHD-R, which was higher in male subgroups. Finally, age was negatively correlated with \u394BMI and \u394FSS. CONCLUSIONS: Though only a relatively limited number of outcomes were investigated, the present study shows that a 4% BW reduction in severely elderly obese patients is associated with positive multisystemic effects, particularly, muscle-skeletal and cardiometabolic benefits, which can favorably influence their general well-being and improve the autonomy level in performing more common daily activities. The maintenance of a healthy life style, including controlled food intake and regular physical activity, after a BWRP is obviously recommended in all elderly obese patients to further improve their clinical condition

Dolore cronico : guida per la gestione evidence-based

Questo libro, scritto con un orientamento prettamente clinico in un formato semplice ma esaustivo, consente agli operatori sanitari di acquisire rapidamente le Linee guida sulla gestione del dolore. Focalizzandosi sulle opzioni terapeutiche destinate ai pazienti con dolore cronico persistente, questa Guida costituisce un utile strumento per la gestione di condizioni considerate difficili, come la fibromialgia e il dolore neuropatico. Il testo, per la trattazione approfondita degli argomenti, assiste l\u2019operatore sanitario nella valutazione del dolore in un\u2019ampia variet\ue0 di popolazioni di pazienti e fornisce indicazioni utili per la propria attivit\ue0 professionale nella selezione dei farmaci e degli interventi terapeutici pi\uf9 appropriati per il singolo paziente, al fine di raggiungere il controllo ottimale del dolore nel soggetto adulto

Basi dell&#8217;efficacia clinica del D-mannosio e dell&#8217;estratto di melagrana nelle infezioni urinarie

Patologie ad elevata incidenza nella popolazione femminile sono gravate da alti tassi di recidiva. La disponibilit\ue0 di combinazioni nutraceutiche pu\uf2 rappresentare una valida alternativa sia per la terapia che per la profilassi delle infezioni urinarie