obesity weight loss and heart failure

Background The current scientific data controversially indicate obesity both as a risk factor for developing congestive heart failure (CHF) and a positive prognostic factor. Aims The present study evaluated the impact of weight loss on clinical and instrumental parameters in a selected group of obese patients with CHF. Methods An overall population of 560 HF patients was sub-grouped on the basis of the Body Mass Index (BMI): 8.2% were underweight (BMI 31). Of the 46 overweight and obese patients, 28 (55.2% men, age 51–80 years) accepted a tailored low-caloric dietary program for at least 4 months. The 28 patients belonged to both obese and overweight groups (BMI>27.8) and were in NYHA classes II–III. Mean follow-up was 5 months. Results The mean loss of body weight was 4 kg in 81.4% of patients, versus 3 kg mean increase in whole (560 patients) population (72.5–75.5 kg). In the 28 patients we recorded a significant ( p <0.05) improvement of NYHA class, better control of arterial blood pressure and statistically significant ( p <0.05) lowering of total cholesterol and triglyceride levels. Conclusions Tailored dietetic program may improve clinical and instrumental parameters in patients with CHF

Time variations in the deep underground muon flux measured by MACRO

More than 30 million of high-energy muons collected with the MACRO detector at the underground Gran Sasso Laboratory have been used to search for flux variations of different natures. Two kinds of studies were carried out: search for periodic variations and for the occurrence of clusters of events. Different analysis methods, including Lomb-Scargle spectral analysis and Scan Test statistics have been applied to the data.Comment: 6 pages, 4 EPS figures. Talk given at the 29th ICRC, Pune, India, 3-10 August 200

Discovery of VHE gamma-rays from Centaurus A

We report the discovery of faint very high energy (VHE, E > 100 GeV) gamma-ray emission from the radio galaxy Centaurus A in deep observations performed with the H.E.S.S. experiment. A signal with a statistical significance of 5.0 sigma is detected from the region including the radio core and the inner kpc jets. The integral flux above an energy threshold of ~250 GeV is measured to be 0.8% of the flux of the Crab Nebula and the spectrum can be described by a power law with a photon index of 2.7 +/- 0.5_stat +/- 0.2_sys. No significant flux variability is detected in the data set. The discovery of VHE gamma-ray emission from Centaurus A reveals particle acceleration in the source to >TeV energies and, together with M 87, establishes radio galaxies as a class of VHE emitters.Comment: 4 pages, 3 figures, submitted as proceeding to the 44th Recontre de Moriond "Very High Energy Phenomena in the Universe", contains an updated SED including the recent Fermi dat

Search for a Lorentz invariance violation contribution in atmospheric neutrino oscillations using MACRO data

Neutrino-induced upward-going muons in MACRO have been analysed in terms of relativity principles violating effects, keeping standard mass-induced atmospheric neutrino oscillations as the dominant source of nu_mu -> nu_tau transitions. The data disfavor these exotic possibilities even at a sub-dominant level, and stringent 90% C.L. limits are placed on the Lorentz invariance violation parameter |Delta v| < 6 * 10^(-24) at sin2theta_v = 0 and |Delta v| < 2.5--5 * 10^(-26) at sin2theta_v = +/-1. These limits can also be re-interpreted as upper bounds on the parameters describing violation of the Equivalence Principle.Comment: 8 pages, 2 figures, submitted to Physics Letters

Management of prostate cancer radiotherapy during the COVID-19 pandemic: A necessary paradigm change

Purpose: To adapt the management of prostate malignancy in response to the COVID-19 pandemic. Methods: In according to the recommendations of the European Association of Urology, we have developed practical additional document on the treatment of prostate cancer. Results: Low-Risk Group Watchful Waiting should be offered to patients &gt;75 years old, with a limited life expectancy and unfit for local treatment. In Active Surveillance (AS) patients re-biopsy, PSA evaluation and visits should be deferred for up to 6 months, preferring non-invasive multiparametric-MRI. The active treatment should be delayed for 6–12 months. Intermediate-Risk Group AS should be offered in favorable-risk patients. Short-course neoadjuvant androgen deprivation therapy (ADT) combined with ultra-hypo-fractionation radiotherapy should be used in unfavorable-risk patients. High-Risk Group Neoadjuvant ADT combined with moderate hypofractionation should be preferred. Whole-pelvis irradiation should be offered to patients with positive lymph nodes in locally advanced setting. ADT should be initiated if PSA doubling time is &lt; 12 months in radio-recurrent patients, as well as in low priority/low volume of metastatic hormone sensitive prostate cancer. If radiotherapy cannot be delayed, hypo-fractionated regimens should be preferred. In high priority class metastatic disease, treatment with androgen receptor-targeted agents should be offered. When palliative radiotherapy for painful bone metastasis is required, single fraction of 8 Gy should be offered. Conclusions: In Covid-19 Era, the challenge should concern a correct management of the oncologic patient, reducing the risk of spreading the virus without worsening tumor prognosis

Toxicity after moderately hypofractionated versus conventionally fractionated prostate radiotherapy: A systematic review and meta-analysis of the current literature

Background: Moderately hypofractionated radiotherapy (RT) currently represents the standard RT approach for all prostate cancer (PCa) risk categories. We performed a systematic review and meta-analysis of available literature, focusing on acute and late genitourinary (GU) and gastrointestinal (GI) adverse events (AEs) of moderate hypofractionation for localized PCa. Materials and methods: Literature search was performed and two independent reviewers selected the records according to the following Population (P) Intervention (I) Comparator (C) and Outcomes (O) (PICO) question: “In patients affected by localized PCa (P), moderately hypofractionated RT (defined as a treatment schedule providing a single dose per fraction of 3–4.5 Gy) (I) can be considered equivalent to conventionally fractionated RT (C) in terms of G &gt; 2 GI and GU acute and late adverse events (O)?”. Bias assessment was performed using Cochrane Cochrane Collaboration's Tool for Assessing Risk of Bias. Results: Thirteen records were identified and a meta-analysis was performed. Risk of acute GI and GU &gt; 2 adverse events in the moderately hypofractionated arm was increased by 9.8 % (95 %CI 4.8 %–14.7 %; I2 = 57 %) and 1.5 % (95 % CI -1.5 %-4.4 %; I2 = 0%), respectively. Discussion: Overall, majority of trials included in our meta-analysis suggested that moderately hypofractionated RT is equivalent, in terms of GI and GU adverse events, to conventional fractionation. Pooled analysis showed a trend to increased GI toxicity after hypofractionated treatment, but this might be related to dose escalation rather than hypofractionation