Mediterranean diet adherence and synergy with acute myocardial infarction and its determinants. a multicenter case-control study in Italy.

Cardiovascular diseases are the leading causes of mortality and morbidity in Western countries. The possible synergistic effect of poor adherence to a Mediterranean diet (MD) and other risk factors for acute myocardial infarction (AMI) such as hypertension, cholesterol, ever smoker, BMI> 25, diabetes, has not been deeply studied. Design Case-control study. Methods Patients with first AMI and controls from four tertiary referral Italian centers were screened for enrolment. Dietary information was collected through a questionnaire and a MD adherence score was calculated. Physical activity and smoking habits were also registered. The Synergy Index was calculated according to Rothman. Results 127 cases and 173 controls were enrolled. The analysis was conducted using a dichotomous variable for the MD score with values 7 representing good adherence. Multivariate analysis showed the following variables associated to AMI: ever smoker (OR = 2.08), diabetes (OR = 1.42), hypertension (OR = 2.08), hypercholesterolemia (OR = 2.47), BMI> 25 (OR = 1.99), while a protective effect emerged both in subjects scoring > 7 on the MD score(OR = 0.55) and in subjects resident of Southern Italy (OR = 0.38). A synergistic effect does exist between poor adherence to the MD and the following risk factors: hypertension, hypercholesterolemia, BMI >25, diabetes and being a resident in central and northern Italy. Conclusion Synergy between heart disease risk factors and MD underlines the need to enlarge the list of known modifiable cardiovascular risk factors to include and promote adherence to Mediterranean dietary habits

Metabolic findings on 3T 1H-MR spectroscopy in peritumoral brain edema.

BACKGROUND AND PURPOSE: Little is known about the metabolic properties of brain edema associated with tumors. This work was conducted on the basis of the assumption that, in the presence of intra-axial and extra-axial brain tumors, the white matter involved by the edema is a site of metabolic change that involves the structure of the myelin sheath. MATERIALS AND METHODS: Thirteen patients comprised our cohort affected by intra-axial and extra-axial cerebral tumors with a peritumoral T2-weighted MR signal hyperintensity as a result of edema, where MR spectroscopy showed no increase in choline-containing compounds. Measurements on proton MR spectroscopy (1H-MR spectroscopy) were performed with a 3T whole-body scanner with use of a point-resolved spectroscopy sequence for localization (TR, 2000 ms; TE, 35 ms), and the metabolites were quantified with the SAGE method. Peak intensities of the main metabolites were expressed as ratios of one another and were compared with values obtained in the white matter of the left frontal region in a control group of 16 healthy volunteers. RESULTS: Choline-to-creatine (Cho/Cr) and myo-inositol-to-creatine (mIns/Cr) signal intensity ratios were normal in all patients. N-acetylaspartate-to-creatine (NAA/Cr) and N-acetylaspartate-to-choline (NAA/Cho) ratios decreased in 4 patients. Glutamate plus glutamine-to-creatine (Glx/Cr) was increased in 10 patients. A resonance peak at 3.44 ppm, strongly suggesting the presence of glucose, was detected in all but 1 patient. Lactate was detected in 12 patients and lipids in 5. Moreover, the resonances that pertained to the aliphatic amino acids valine, leucine, and isoleucine were present in 12 patients. CONCLUSIONS: Our findings on MR spectroscopy confirmed the hypothesis that in the edema surrounding brain tumors, an energy-linked metabolic alteration was associated with injury to the myelin sheath

Myocarditis and intramural coronary vasculitis in polyarteritis nodosa: an unusual treatable form of heart failure

We describe an uncommon cardiac presentation of polyarteritis nodosa. A 68-year-old woman, with a history of fatigue, weight loss, and myalgia of the lower extremities, was admitted for congestive heart failure. Coronary arteries were normal. Endomyocardial biopsy showed active lymphocytic myocarditis with associated intramural small vessels necrotizing vasculitis. The overexpression of TLR-4 and the negativity for myocardial viruses suggested an immune mediated mechanism of cardiac damage. These histologic findings associated to weight loss >4 kg not due to dieting or other factors, myalgias, and polyneuropathy, were consistent with the diagnosis of polyarteritis nodosa. Immunosuppressive treatment, consisting of cyclophosphamide and prednisolone, led to a significant improvement of cardiac function. Polyarteritis nodosa can be the cause of unexplained heart failure due to myocarditis and intramural vessels vasculitis. Its recognition is crucial to obtain a cardiac recovery with a tailored immunosuppressive treatment

Influence of residual perfusion within the infarct zone on the natural history of left ventricular dysfunction after acute myocardial infarction.

This study used myocardial contrast echocardiography to investigate the extent of residual perfusion within the infarct zone in a select group of patients with recently reperfused myocardial infarction and evaluated its influence on the ultimate infarct size. BACKGROUND: Limited information is available on the status of myocardial perfusion within postischemic dysfunctional segments at predischarge and on its influence on late regional and global functional recovery. METHODS: Twenty patients with acute myocardial infarction were selected for the study. Patients met the following inclusion criteria: 1) single-vessel coronary artery disease; 2) patency of infarct-related artery with persistent postischemic dysfunctional segments at predischarge; 3) stable clinical condition up to 6 months after hospital discharge. All selected patients underwent coronary angiography and myocardial contrast echocardiography before hospital discharge and repeated the echocardiographic examination 6 months later. Patients were grouped according to the pattern of contrast enhancement in predischarge dysfunctional segments. RESULTS: In nine patients (group I), the length of segments showing abnormal contraction coincided with that of the contrast defect segments. In the remaining 11 patients (group II), postischemic dysfunctional segments were partly or completely reperfused. There was no difference between the two groups in asynergic segment length at predischarge (7.3 +/- 2.5 vs. 7.2 +/- 4.3 cm, p = NS). At follow-up study, asynergic segment length was significantly reduced in group II patients, whereas no changes were observed in group I patients (from 7.2 +/- 4.3 to 4.7 +/- 3.7 cm, p < 0.005; and from 7.3 +/- 2.5 to 7.5 +/- 2.9 cm, p = NS, respectively). CONCLUSIONS: Among patients with a predischarge patent infarct-related artery, further improvement in regional and global function may be expected during follow-up when residual perfusion in the infarct zone is present

FluorMODgui V3.0: A Graphic User Interface for the Spectral Simulation of Leaf and Canopy Chlorophyll Fluorescence

The FluorMODgui Graphic User Interface (GUI) software package developed within the frame of the FluorMOD project Development of a Vegetation Fluorescence Canopy Model is presented in this manuscript. The FluorMOD project was launched in 2002 by the European Space Agency (ESA) to advance the science of vegetation fluorescence simulation through the development and integration of leaf and canopy fluorescence models based on physical methods. The design of airborne or space missions dedicated to the measurement of solar-induced chlorophyll fluorescence using remote-sensing instruments require physical methods for quantitative feasibility analysis and sensor specification studies. The FluorMODgui model developed as part of this project is designed to simulate the effects of chlorophyll fluorescence at leaf and canopy levels using atmospheric inputs, running the leaf model, FluorMODleaf, and the canopy model, FluorSAIL, independently, through a coupling scheme, and by a multiple iteration protocol to simulate changes in the viewing geometry and atmospheric characteristics. Inputs for the FluorMODleaf model are the number of leaf layers, chlorophyll a+b content, water equivalent thickness, dry matter content, fluorescence quantum efficiency, temperature, species type, and stoichiometry. Inputs for the FluorSAIL canopy model are a MODTRAN-4 6-parameter spectra or measured direct horizontal irradiance and diffuse irradiance spectra, a soil reflectance spectrum, leaf reflectance & transmittance spectra and a excitation-fluorescence response matrix in upward and downward directions (all from FluorMODleaf), 2 PAR-dependent coefficients for the fluorescence response to light level, relative azimuth angle and viewing zenith angle, canopy leaf area index, leaf inclination distribution function, and a hot spot parameter. Outputs available in the 400-1000 nm spectral range from the graphical user interface, FluorMODgui, are the leaf spectral reflectance and transmittance, and the canopy reflectance, with and without fluorescence effects. In addition, solar and sky irradiance on the ground, radiance with and without fluorescence on the ground, and top-of-atmosphere (TOA) radiances for bare soil and surroundings same as target are also produced. The models and documentation regarding the FluorMOD project can be downloaded at http://www.ias.csic.es/fluormod

Identification of mobile lipids in human cancer tissues by ex vivo diffusion edited HR-MAS MRS

Magnetic Resonance Spectroscopy visible mobilelipids are considered important markers in the diagnosis ofhuman cancer and are thought to be closely involved in variousaspects of tumour transformation, such as cell proliferation,necrosis, apoptosis, hypoxia and drug resistance. A methodallowing the straightforward identification of the lipid classescontributing to the mobile lipids in human malignant tissuesis highly advisable. Ex vivo High Resolution Magic AngleSpinning Magnetic Resonance Spectroscopy was done directlyon human cerebral, renal and colorectal malignant tissuespecimens. A diffusion edited sequence, based on stimulatedecho and bipolar gradient pulses, was used to characterizemolecules with low diffusion rates, arising from mobile lipidcomponents. Cholesterol, triglycerides and phosphatidylcholineare simultaneously detected and all contribute to the mobilelipid resonances present in malignant glioma and clear cellrenal carcinoma tissue specimens spectra. On the contrary,papillary cell renal carcinoma spectrum is predominated byphosphatidylcholine resonances and that of colorectal adenocarcinoma is characterized by signals arising from triglycerides. Ex vivo diffusion edited High Resolution Magic AngleSpinning Magnetic Resonance Spectroscopy, done on intacttissue, is a powerful analytical tool to obtain a simple andimmediate identification of mobile lipid components. This can offer a significant contribution to better understanding their involvement in cancer tissues. Furthermore, ex vivo high resolution spectroscopic measurements allow to improve the interpretation of in vivo Magnetic Resonance spectra, increasing its clinical potentiality

Quantitative detection of myocardial ischaemia by stress echocardiography; a comparison with SPECT

<p>Abstract</p> <p>Aims</p> <p>Real-time perfusion (RTP) adenosine stress echocardiography (ASE) can be used to visually evaluate myocardial ischaemia. The RTP power modulation technique angio-mode (AM), provides images for off-line perfusion quantification using Qontrast^®software, generating values of peak signal intensity (A), myocardial blood flow velocity (β) and myocardial blood flow (Axβ). By comparing rest and stress values, their respective reserve values (A-r, β-r, Axβ-r) are generated. We evaluated myocardial ischaemia by RTP-ASE Qontrast^®quantification, compared to visual perfusion evaluation with ^99mTc-tetrofosmin single-photon emission computed tomography (SPECT).</p> <p>Methods and Results</p> <p>Patients admitted to SPECT underwent RTP-ASE (SONOS 5500) using AM during Sonovue^®infusion, before and throughout adenosine stress, also used for SPECT. Visual myocardial perfusion and wall motion analysis, and Qontrast^®quantification, were blindly compared to one another and to SPECT, at different time points off-line.</p> <p>We analyzed 201 coronary territories (left anterior descendent [LAD], left circumflex [LCx] and right coronary [RCA] artery territories) in 67 patients. SPECT showed ischaemia in 18 patients and 19 territories. Receiver operator characteristics and kappa values showed significant agreement with SPECT only for β-r and Axβ-r in all segments: area under the curve 0.678 and 0.665; P < 0.001 and < 0.01, respectively. The closest agreements were seen in the LAD territory: kappa 0.442 for both β-r and Axβ-r; P < 0.01. Visual evaluation of ischaemia showed good agreement with SPECT: accuracy 93%; kappa 0.67; P < 0.001; without non-interpretable territories.</p> <p>Conclusion</p> <p>In this agreement study with SPECT, RTP-ASE Qontrast^®quantification of myocardial ischaemia was less accurate and less feasible than visual evaluation and needs further development to be clinically useful.</p

Potential of a multiparametric optical sensor for determining in situ the maturity components of red and white vitis vinifera wine grapes

A non-destructive fluorescence-based technique for evaluating Vitis vinifera L. grape maturity using a portable sensor (Multiplex ®) is presented. It provides indices of anthocyanins and chlorophyll in Cabernet Sauvignon, Merlot and Sangiovese red grapes and of flavonols and chlorophyll in Vermentino white grapes. The good exponential relationship between the anthocyanin index and the actual anthocyanin content determined by wet chemistry was used to estimate grape anthocyanins from in field sensor data during ripening. Marked differences were found in the kinetics and the amount of anthocyanins between cultivars and between seasons. A sensor-driven mapping of the anthocyanin content in the grapes, expressed as g/kg fresh weight, was performed on a 7-ha vineyard planted with Sangiovese. In the Vermentino, the flavonol index was favorably correlated to the actual content of berry skin flavonols determined by means of HPLC analysis of skin extracts. It was used to make a non-destructive estimate of the evolution in the flavonol concentration in grape berry samplings. The chlorophyll index was inversely correlated in linear manner to the total soluble solids (°Brix): it could, therefore, be used as a new index of technological maturity. The fluorescence sensor (Multiplex) possesses a high potential for representing an important innovative tool for controlling grape maturity in precision viticulture