A Multifunctional Bread Rich in Beta Glucans and Low in Starch Improves Metabolic Control in Type 2 Diabetes: A Controlled Trial

Abstract: Design: Functional foods may be useful for people with diabetes. The soluble fibers beta glucans can modify starch digestion and improve postprandial glucose response. We analyzed the metabolic effects of a specifically designed \u2018functional\u2019 bread, low in starch, rich in fibers (7 g/100 g), with a beta glucan/starch ratio of (7.6:100, g/g), in people with type 2 diabetes mellitus. Methods: Clinical and metabolic data from two groups of age-, sex- and glycated hemoglobin-matched diabetic subjects, taking either the functional bread or regular white bread, over a roughly six-month observation period, were retrieved. Results: Bread intake did not change during the trial. The functional bread reduced glycated hemoglobin by ~0.5% (absolute units) vs. pre-treatment values (p = 0.028), and by ~0.6% vs. the control group (p = 0.027). Post-prandial and mean plasma glucose was decreased in the treatment group too. Body weight, blood pressure and plasma lipids did not change. The acceptance of the functional bread was good in the majority of subjects, except for taste. Conclusions: A starch-restricted, fiber-rich functional bread, with an increased beta glucan/starch ratio, improved long term metabolic control, and may be indicated in the dietary treatment of type 2 diabetes

Essential amino acids: master regulators of nutrition and environmental footprint?

The environmental footprint of animal food production is considered several-fold greater than that of crops cultivation. Therefore, the choice between animal and vegetarian diets may have a relevant environmental impact. In such comparisons however, an often neglected issue is the nutritional value of foods. Previous estimates of nutrients\u2019 environmental footprint had predominantly been based on either food raw weight or caloric content, not in respect to human requirements. Essential amino acids (EAAs) are key parameters in food quality assessment. We re-evaluated here the environmental footprint (expressed both as land use for production and as Green House Gas Emission (GHGE), of some animal and vegetal foods, titrated to provide EAAs amounts in respect to human requirements. Production of high-quality animal proteins, in amounts sufficient to match the Recommended Daily Allowances of all the EAAs, would require a land use and a GHGE approximately equal, greater o smaller (by only \ub11-fold), than that necessary to produce vegetal proteins, except for soybeans, that exhibited the smallest footprint. This new analysis downsizes the common concept of a large advantage, in respect to environmental footprint, of crops vs. animal foods production, when human requirements of EAAs are used for reference

Elastic stockings effect on leg volume variability in healthy workers under prolonged gravitational gradient exposure

The aim of this study was to determine the elastic stockings effect on healthy workers (HW) who are exposed to a prolonged hydrostatic pressure overload for professional reasons. The cohort was composed by 20 HW who voluntarily underwent a water plethysmography test before and after eight hour of standing up in an operating room, wearing elastic stockings. After 8 h of gravity exposure, we demonstrated the absence of leg volume increase in case of elastic stockings use. In the morning measurement we found that the lower limb volume was 1967.5 mL±224, while in the evening it was 1962.5 mL±227 (P<0.0828). The decreased volume is significantly correlated with the time that was spent under gravity forces for working purpose wearing elastic stockings (R2=0.99, P<0.0001). Our experiment demonstrates that elastic stockings may effectively counteract the increased leg volume over time in workers who are exposed to prolonged gravitational gradient. Further longitudinal studies are needed to determine if the above effect could correct one of the major risk factors for the development of chronic venous insufficiency

A specifically designed aquatic exercise protocol to reduce chronic lower limb edema

Objective Despite the fact that muscle pump activation is known to positively impact chronic lower limb edema, objective measurements of standardized exercises for venous-lymphatic rehab are lacking. The aim of this investigation is to determine the effectiveness of an addressed physical activity exploiting the advantages of an aquatic environment.Material and methods Thirty-two lower limbs of 16 patients affected by bilateral chronic leg swelling were included (12 females, 4 males). All the patients underwent a protocol of five sessions of physical exercises specifically conceived inside a pool. Volumetry, subcutaneous thickness, ankle range of motion and symptomatology were assessed as outcome measures.Results One week after the end of the protocol, the average reduction in lower limb volume was 303.1369.72ml (p=0.00002) and 334.38 +/- 62.50ml (p=0.000003) in the right and left legs, respectively. Ankle range of motion and feeling of heaviness significantly improved.Conclusion A specifically designed aquatic protocol is able to positively impact chronic leg swelling offering a first line rehab for this medical condition

Assessment of lower limbs edema in healthy workers who are exposed to long-term gravity

The aim of this study is to establish changes in leg volumes in healthy subjects (HS) after prolonged standing and prolonged lying. The study was carried out on two HS groups: the group A (20 subjects) included physicians and nurses who underwent a water plethysmography test, before and after eight hours of standing still in the operating room. The group B (20 subjects) included volunteers who were assessed before and after 10 h of supine resting. Group A: baseline leg volume was 1857.5 mL±196.9 on the right and 1850 mL±194.7 on the left limb. After eight hours of hydrostatic pressure action the two lower limbs volume was significantly increased to 1945 mL±209.6, and to 1940 mL±216.2, respectively (P<0.0001). The increased volume is significantly correlated with time (R2=0.95, P<0.0001). Group B: baseline leg volume was 1875 mL±175.1 on the right, and 1862.5 mL±166.9 on the left limb. After ten hours of resting supine the volume was 1770 mL±195.6, and to 1757.5 mL±194.2, respectively (P<0.0001). The decreased volume is significantly but inverted correlated with time (R2=−0.98, P<0.0001). This study demonstrates how the hydrostatic pressure is a main determinant for fluid accumulation in the lower extremity. To counteract the gravitational gradient becomes the mandatory prophylactic approach for healthy individuals who are exposed to an increased chronic venous disease risk

A novel device for non-invasive cerebral perfusion assessment

Currently brain perfusion can be assessed by the means of radio-invasive methods, such as single-photon emission computed tomography and positron emission tomography, or by hightech methods such as magnetic resonance imaging. These methods are known to be very expensive, with long examination time, and finally, cannot be used for assessing brain oxygen distribution in relation to exercise and/or cognition-tests. The near infrared spectroscopy (NIRS) is a non-invasive diagnostic technique. In real time it is capable of measuring tissue oxygenation using portable instrumentation with a relative low cost. We and other groups previously adopted this instrument for investigation of the oxygen consumption in the muscles at rest and during exercise. NIRS can be now used to assess brain perfusion through the intact skull in human subjects by detecting changes in blood hemoglobin concentrations. Changes in perfusion can be related to both arterial and venous problems. This novel equipment features allow for a wide field of innovative applications where portability, wearability, and a small footprint are essential. The present review shows how to use it in relation to exercise protocols of the upper and lower extremities, measured in healthy people and in conditions of arterial and chronic cerebro-spinal venous insufficiency

Technique for intraoperatory harvesting of adipose derived stem cells: towards cell treatment of recalcitrant ulcers

Successful wound and ulcer repair remains a major biomedical challenge in the 21st Century. Innovative and alternative treatment options have been investigated over the last decade and stem cells application has been suggested as a possible novel therapy for regenerative medicine. In particular, stem cells derived from adipose tissue have been attracting a lot of attention in recent years as an alternative to the use of cells derived from bone marrow. This technical note describes the procedure introduced by Coleman for intraoperatory harvesting of adipose derived-stem-cells and proposes a rationale for using it in difficult wound healing and recalcitrant ulcers

Stima della prevalenza di broncopneumopatia cronico-ostruttiva basata su dati sanitari correnti, mediante l\u27uso di un algoritmo comune, in differenti aree italiane

Aim: to estimate the prevalence of chronic obstructive pulmonary disease (COPD) by integrating various administrative health information systems. Methods: prevalent COPD cases were defined as those reported in the hospital discharge registry (HDR) and cause of mortality registry (CMR) with codes 490*, 491*, 492*, 494* e 496* of the International diseases classification 9th revision. Annual prevalence was estimated in 35+ year-old residents in six Italian areas of different sizes, in the period 2002-2004. We in- Annunziata Faustini,1 Silvia Cascini,1 Massimo Arc?,1 Daniela Balzi,2 Alessandro Barchielli,2 Cristina Canova,3 Claudia Galassi,4 Enrica Migliore,4,5 Sante Minerba,6 Maria Angela Protti,7 Anna Romanelli,7 Roberta Tessari,3,8 Maria Angela Vigotti,9 Lorenzo Simonato3 1Dipartimento di epidemiologia, ASL RME, Roma 2Unit? operativa di epidemiologia, Azienda sanitaria 10, Firenze 3Dipartimento di medicina ambientale e sanit? pubblica, Universit? di Padova 4Servizio di epidemiologia dei tumori, ASO S. Giovanni Battista, CPO Piemonte e Universit? di Torino 5Unit? di pneumologia, CPA-ASL TO2, Torino 6Unit? di statistica ed epidemiologia, ASL 1 Taranto 7Sezione di epidemiologia e ricerca sui servizi sanitari, IFC-CNR, Pisa 8Unit? di epidemiologia, Dipartimento di prevenzione, Azienda ULSS 12 Veneziana 9Dipartimento di biologia, Universit? di Pisa Corrispondenza: Annunziata Faustini, Dipartimento di epidemiologia, ASL RME, via Santa Costanza 53, 00198 Roma; tel. 06 86060486; fax 06 86060463; e-mail [email protected] cluded cases observed in the previous four years who were alive at the beginning of each year. Results: in 2003, age-standardized prevalence rates varied from 1.6% in Venice to 5% in Taranto. Prevalence was higher in males and increased with age. The highest rates were observed in central (Rome) and southern (Taranto) cities, especially in the 35-64 age group. HDR contributed 91% of cases. Healthtax exemption registry would increase the prevalence estimate by 0.2% if used as a third data source. Conclusions: with respect to the National Health Status suraldelvey, COPD prevalence is underestimated by 1%-3%; this can partly be due to the selection of severe and exacerbated COPD by the algorithm used. However, age, gender and geographical characteristics of prevalent cases were comparable to national estimates. Including cases observed in previous years (longitudinal estimates) increased the point estimate (yearly) of prevalence two or three times in each area.Obiettivi: stimare la prevalenza della broncopneumopatia cronico-ostruttiva (BPCO) mediante l\u27utilizzo integrato di dati sanitari correnti. Metodi: la prevalenza ? stata stimata nella popolazione residente di et? superiore ai 34 anni, in sei aree geografiche, per gli anni 2002-2004. I casi prevalenti sono stati individuati dai registri delle schede di dimissione ospedaliera (SDO) e delle cause di morte (RCM), mediante i codici ICD9-CM 490*, 491*, 492*, 494* e 496* della Classificazione internazionale delle malattie 9? revisione (ICD9-CM). Ai casi osservati in ciascun anno sono stati aggiunti i pazienti ricoverati nei quattro anni precedenti e vivi all\u27inizio dell\u27anno di stima. Risultati: la prevalenza della BPCO, stimata mediante tassi standardizzati per et?, varia per il 2003 dall\u271,6% di Venezia sural 5% di Taranto. La prevalenza ? pi? alta negli uomini e aumenta con l\u27et?; Taranto e Roma presentano i valori pi? elevati, specialmente nelle classi d\u27et? dai 35 ai 64 anni. Fonte principale dei casi sono i ricoveri ospedalieri, con un contributo di almeno il 91%. L\u27uso delle esenzioni ticket come terza fonte incrementa la stima di prevalenza dello 0,2%. Conclusioni: la prevalenza della BPCO ? sottostimata dell\u271%-3% rispetto ai dati dell\u27indagine Istat sullo stato di salute; questo ? in parte attribuibile alla selezione dei casi medio- gravi da parte dell\u27algoritmo utilizzato. Tuttavia le stime mantengono le caratteristiche attese nella distribuzione per genere, et? e area geografica. Inoltre, l\u27uso longitudinale dei dati ospedalieri aumenta di 2-3 volte la stima di prevalenza basata sui dati dei singoli anni