Beat-to-beat finger photoplethysmography in atrial fibrillation patients undergoing electrical cardioversion

Atrial fibrillation (AF)-induced peripheral microcirculatory alterations have poorly been investigated. The present study aims to expand current knowledge through a beat-to-beat analysis of non-invasive finger photoplethysmography (PPG) in AF patients restoring sinus rhythm by electrical cardioversion (ECV). Continuous non-invasive arterial blood pressure and left middle finger PPG pulse oximetry waveform (POW) signals were continuously recorded before and after elective ECV of consecutive AF or atrial flutter (AFL) patients. The main metrics (mean, standard deviation, coefficient of variation), as well as a beat-to-beat analysis of the pulse pressure (PP) and POW beat-averaged value (aPOW), were computed to compare pre- and post-ECV phases. 53 patients (mean age 69 ± 8 years, 79% males) were enrolled; cardioversion was successful in restoring SR in 51 (96%) and signal post-processing was feasible in 46 (87%) patients. In front of a non-significant difference in mean PP (pre-ECV: 51.96 ± 13.25, post-ECV: 49.58 ± 10.41 mmHg; p = 0.45), mean aPOW significantly increased after SR restoration (pre-ECV: 0.39 ± 0.09, post-ECV: 0.44 ± 0.06 a.u.; p 95th percentile) and short (< 5th percentile) RR intervals were significantly more irregular in the pre-ECV phases for both PP and aPOW; however, aPOW signal suffered more fluctuations compared to PP (p < 0.001 in both phases). Present findings suggest that AF-related hemodynamic alterations are more manifest at the peripheral (aPOW) rather than at the upstream macrocirculatory level (PP). Restoring sinus rhythm increases mean peripheral microvascular perfusion and decreases variability of the microvascular hemodynamic signals. Future dedicated studies are required to determine if AF-induced peripheral microvascular alterations might relate to long-term prognostic effects

Bovine leukemia viral DNA found on human breast tissue is genetically related to the cattle virus

Bovine leukemia virus (BLV) infection is widespread in cattle and associated with B cell lymphoma. In a previousstudy we demonstrated that bovine leukemia viral DNA was detected in human breast tissues and significantly associated with breast cancer. Our current study aimed to determine whether BLV DNA found in humans and cattle at the same geographical region were genetically related. DNA was extracted from the breast tissue of healthy (n = 32) or cancerous women patients (n = 27) and from the blood (n = 30) of cattle naturally infected with BLV, followed by PCR-amplification and partial nucleotide sequencing of the BLV env gene. We found that the nucleotide sequence identity between BLV env gene fragments obtained from human breast tissue and cattle blood ranged from 97.8 to 99.7% and grouped into genotype 1. Thus, our results further support the hypothesis that this virus might cause a zoonotic infection

Increased beat-to-beat variability of cerebral microcirculatory perfusion during atrial fibrillation: a near-infrared spectroscopy study

Aims Atrial fibrillation (AFib) is associated with cognitive decline/dementia, independently from clinical strokes or transient ischaemic attacks (TIA). Recent in silico data suggested that AFib may induce transient critical haemodynamic events in the cerebral microcirculation. The aim of this study is to use non-invasive spatially resolved cerebral near-infrared spectroscopy (SRS-NIRS) to investigate in vivo beat-To-beat microcirculatory perfusion during AFib and after sinus rhythm (SR) restoration. Methods and results Cerebral SRS-NIRS with high-frequency sampling (20 Hz) and non-invasive systemic haemodynamic monitoring were recorded before and after elective electrical cardioversion (ECV) for AFib or atrial flutter (AFL). To assess beat-To-beat effects of the rhythm status, the frequency distribution of inter-beat differences in tissue haemoglobin index (THI), a proxy of microcirculatory cerebral perfusion, was compared before and after SR restoration. Fiftythree AFib/AFL patients (mean age 69 ± 8 years, 79% males) were ultimately enrolled. Cardioversion was successful in restoring SR in 51 (96%) patients. In front of a non-significant decrease in arterial blood pressure extreme events between pre-and post-ECV measurements, a significant decrease of both hypoperfusive and hyperperfusive/hypertensive microcirculatory events was observed after SR restoration (P<0.001 and P = 0.041, respectively). Conclusion The present is the first in vivo demonstration that SR restoration by ECV significantly reduces the burden of extreme single-beat haemodynamic events in cerebral microcirculation. Future studies are needed to assess whether SR maintenance might slow long-Term AFib-correlated cognitive decline/dementia

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

Self-regulation in adopting the Mediterranean diet: an experimental study

Despite its advantages, the Mediterranean diet (MD) is still under-diffused, making it necessary to understand the psychological variables underlying its adoption. Using an integrated model of Theory of Planned Behavior (TPB) and Self-Determination Theory (SDT), the present study evaluated the efficacy of experimentally manipulating motivation (autonomous vs controlled) to change intention and MD adherence. The study consisted of two phases, with a time lag of two weeks. At T1, 726 Italian adults were randomly allocated to one of three conditions: autonomous motivation, controlled motivation and control group. In the experimental conditions, participants answered a verbal stimulus aimed at increasing their autonomous or controlled motivation to adhere to MD. TPB and SDT variables were measured at T1, except for the behavior, which was measured at T2, along with a second measurement of motivation. Participants in the autonomous motivation condition reported higher intention, attitude and autonomous motivation (both at T1 and T2) than those in the control group. Nevertheless, no change in behavior was found. Our study showed the effectiveness of targeting motivation to promote intention to adhere to MD, also suggesting the importance of further exploring the intention-behavior gap

The role of autonomous motivation in predicting the adherence to the Mediterranean diet

The study explores the role of autonomous motivation in the Theory of Planned Behavior (TPB; Ajzen, 1991) applied to the adherence to the Mediterranean diet. The hypothesized model integrates the TPB (extended with descriptive norm) with the inclusion of autonomous motivation, a construct from self-determination theory (SDT; Deci & Ryan, 1985). The autonomous motivation reflects personally endorsed, self-referenced reasons for acting. The main aim was to test whether autonomous motivation moderates the relationship between intention and behavior. The study was conducted in two phases, with a time lag of two weeks. In the first phase, the online structured questionnaire included measures of intention and its antecedents and items to detect autonomous motivation. In the second, the behavior of adherence to the Mediterranean diet in the previous two weeks was surveyed. A convenience sample of 225 Italian adults (66.7% were university students) participated in the study. Results of the regression analyses proved that the TPB-extended model explained 66.2% of the intention variance, and 15.3% of behavior variance. Affective attitude, descriptive norm, perceived behavioral control and autonomous motivation were significantly related to intention. Behavior was directly predicted by intention. Furthermore, autonomous motivation moderated the effect of intention on behavior, which was significant only when autonomous motivation was high. In conclusion, the results support the importance of integrating SDT and TPB in predicting the intention to adhere to this healthy and sustainable diet and the usefulness of this integration in order to better understand the intention-behavior gap

Prevedere l'aderenza alla dieta mediterranea integrando la teoria del comportamento pianificato con la teoria dell'autodeterminazione

La Dieta Mediterranea (DM) è uno dei regimi alimentari più sani e sostenibili. Tuttavia, la sua diffusione è ancora limitata e ciò indica la necessità di comprendere i fattori psicosociali che prevedono e promuovono la sua adozione. Il modello ipotizzato nella ricerca integra la teoria del comportamento pianificato (Theory of Planned Behavior, TPB) e la teoria dell'autodeterminazione (Self-Determination Theory, SDT) e considera anche il comportamento passato di adesione alla DM nelle ultime due settimane, come variabile esterna. La ricerca si è svolta in due fasi, T1 e T2. I partecipanti erano 706 adulti italiani (60.5% donne; età media 32 anni). La motivazione autonoma e controllata esterna, i costrutti della TPB e il comportamento passato sono stati misurati al T1; mentre il comportamento di adesione alla DM è stato rilevato due settimane dopo (T2). Il modello ipotizzato è stato testato mediante path analysis. I risultati hanno evidenziato che il modello integrato spiega il 59% della varianza dell’intenzione e il 36% di quella del comportamento. I costrutti della TPB, a parte l’atteggiamento cognitivo, sono risultati associati all’intenzione la quale prevede l’adesione alla DM al T2. Solo la motivazione autonoma è associata direttamente e indirettamente all’intenzione, grazie alla mediazione dell’atteggiamento affettivo, della norma descrittiva e del controllo comportamentale percepito. Il comportamento passato è direttamente e indirettamente associato al comportamento al T2, grazie ai suoi effetti sulla motivazione autonoma, sul controllo comportamentale percepito e sull’intenzione. I risultati sostengono l'integrazione della TPB e della SDT, suggerendo che la motivazione autonoma e il comportamento passato svolgono un ruolo centrale nel processo che porta a scegliere di seguire questo regime alimentare sano e sostenibile