Nutrition in preschool children and later risk of obesity: a systematic review and meta analysis

Objectives and study: Nutrition in infants and preschool children has been suggested to influence the risk of later obesity. However, the evidence for this association is conflicting and few studies have investigated this prospectively or considered the role of energy and specific macronutrients. Here we report a systematic review and meta-analyis of studies that tested the hypothesis that nutrition in the preschool period, between the ages of 6 months and 3 years, is associated with later obesity risk. Methods: MEDLINE, EMBASE and CENTRAL databases were searched from January 1988 to June 2015 for studies reporting nutritional intake in infants and preschool children aged 6-36 months and later measures of obesity. Bibliographies of included studies were hand searched and authors and other experts consulted to identify omissions. We included all studies that investigated dietary energy and/or macronutrient intake during 6-36 months in relation to later measures of obesity. Methodological quality was assessed using the Downs and Black checklist designed specifically to appraise both randomised and non-randomised studies. The checklist was adapted to include aspects of particular relevance to studies investigating nutritional exposures. Two reviewers independently scored studies against the 28 item checklist which included questions on study reporting, external validity, internal validity (bias and confounding), and statistical power. A statistician independently scored questions relating to statistical methods and their decision was final. Data from studies amenable to meta-analysis were analysed using STATA (StataCrop 12, Texas). For continuous outcomes, results were expressed as standardised mean difference (SMD) between the high and low protein intake groups. For dichotomous outcomes, results for each study were expressed as relative risk (RR). Both dichotomous and continuous outcomes were presented with 95% confidence intervals (CI). Between-study heterogeneity was assessed by the Q and I2 statistics. Results: 24 eligible articles (comprising 16 primary studies) were included in a narrative synthesis, and 13 studies in a random-effects meta-analysis. A higher protein intake was associated with later risk of obesity in 15 studies. In 13 studies included in the meta-analysis protein in the preschool period was associated with higher BMI z-score later in childhood (pooled effect size: 0.28 z-scores, 95% CI 0.20 to 0.35)(Figure 1). There was no significant hererogeneity between studies (I2 0.0%, p = 0.932). Associations of energy, fat and carbohydrate were inconclusive. Conclusion: Our findings suggest that nutrition and particularly high protein intake in infants and preschool children is important for risk of later obesity. Although further experimental data are required to establish causality, these findings suggest that optimising the protein intake of these children could be important for their long term health

Industrial trials on coadjuvants in olive oil extraction process: Effect on rheological properties, energy consumption, oil yield and olive oil characteristics

The present work deals with industrial scale trials aimed to investigate on rheological properties, energy consumption, oil yield and olive oil quality when the calcium carbonate was used during the extraction process. No statistical differences were found in terms of extraction yields. Regarding analytical results of oils, no significant differences were found when comparing oils obtained with or without carbonate and all of them could be classified as “extra virgin olive oil” according to European rules. The use of calcium carbonate does increase the apparent viscosity of the olive paste without, for this, affecting the performance of the machines. The use, as a technological coadjuvant, of calcium carbonate, can bring towards a reduction of the malaxation time. This can have an advantage in terms of the increasing of work capacity of the plant and the reduction of the total energy employed for the extraction process

Rapid and Non-Destructive Techniques for the Discrimination of Ripening Stages in Candonga Strawberries

Electronic nose (e-nose), attenuated total reflection-Fourier transform infrared (ATR-FTIR) spectroscopy and image analysis (IA) were used to discriminate the ripening stage (half-red or red) of strawberries (cv Sabrosa, commercially named Candonga), harvested at three different times (H1, H2 and H3). Principal component analysis (PCA) performed on the e-nose, ATR-FTIR and IA data allowed us to clearly discriminate samples based on the ripening stage, as in the score space they clustered in distinct regions of the plot. Moreover, a correlation analysis between the e-nose sensor and 57 volatile organic compounds (VOCs), which were overall detected in all the investigated fruit samples by headspace solid-phase microextraction coupled to gas chromatography-mass spectrometry (HS-SPME/GC-MS), allowed us to distinguish half-red and red strawberries, as the e-nose sensors gave distinct responses to samples with different flavours. Three suitable broad bands were individuated by PCA in the ATR-FTIR spectra to discriminate half-red and red samples: the band centred at 3295 cm−1 is generated by compounds that decline, whereas those at 1717 cm−1 and at 1026 cm−1 stem from compounds that accumulate during ripening. Among the chemical parameters (titratable acidity, total phenols, antioxidant activity and total soluble solid) assayed in this study, only titratable acidity was somehow correlated to ATR-FTIR and IA patterns. Thus, ATR-FTIR spectroscopy and IA might be exploited to rapidly assess titratable acidity, which is an objective indicator of the ripening stage

Chronic thromboembolic pulmonary hypertension risk score evaluation and validation (CTEPH Solution). proposal of a study protocol aimed to realize a validated risk score for early diagnosis

Chronic Thromboembolic Pulmonary Hypertension (CTEPH) is the most serious long-term complication of acute pulmonary embolism (PE) though it is the only potentially reversible form of Pulmonary Hypertension (PH). Its incidence is mainly limited to the first 2 years following the embolic event, however it is often underdiagnosed or misdiagnosed

The paradox of pulmonary arterial hypertension in Italy in the COVID-19 era: is risk of disease progression around the corner?

36noObjective The coronavirus disease-2019 (COVID-19) oubreak has led to significant restrictions on routine medical care. We conducted a multicenter nationwide survey of PAH patients aiming at determining the consequences of the Governance measures on PAH management and risk of poor outcome in patients with COVID-19. Meterials and Methods Demographic data, number of in-person visits, 6-min walk and echocardiographic tests, BNP/NT-proBNP tests, WHO functional class assessment, presence of elective and non-elective hospitalisation, need for treatment escalation/initiation, newly diagnosed PAH, incidence of COVID-19 and mortality rates were considered in the present study including 25 Italian centers. Data were collected, double checked and tracked by institutional records, between the 1st March and 1st May 2020 to coincide with the first peak of COVID-19 and compared with the same time-period in 2019. Results Among 1922 PAH patients the incidence of SARS- CoV-2 infection and COVID-19 was 1.0% and 0.46%, respectively, the latter comparable to the overall Italian population (0.34%), but associated with 100% mortality. Less systematic activities were converted into more effective remote interfacing between clinicians and PAH patients allowing lower rates of hospitalisation and related death compared with 2019 (1.2% and 0.3% versus 1.9% and 0.5%, respectively; p<0.001). High level of attention is needed to avoid the potential risk of disease progression related to less aggressive escalation of treatment and the reduction in new PAH diagnosis compared with 2019. Conclusion Cohesive partnership of health care providers with regional public health officials is needed to prioritise PAH patients for remote monitoring by dedicated tools.noneopenRoberto Badagliacca, Silvia Papa, Michele D'Alto, Stefano Ghio, Piergiuseppe Agostoni, Pietro Ameri, Paola Argiento, Natale Daniele Brunetti, Vito Casamassima, Gavino Casu, Nadia Cedrone, Marco Confalonieri, Marco Corda, Michele Correale, Carlo D'Agostino, Lucrezia De Michele, Giulia Famoso, Giuseppe Galgano, Alessandra Greco, Carlo Mario Lombardi, Giovanna Manzi, Rosalinda Madonna, Valentina Mercurio, Massimiliano Mulè, Giuseppe Paciocco, Antonella Romaniello, Emanuele Romeo, Laura Scelsi, Walter Serra, Davide Stolfo, Matteo Toma, Marco Vatrano, Patrizio Vitulo, Pietro Geri, Paola Confalonieri, Carmine Dario VizzaBadagliacca, Roberto; Papa, Silvia; D'Alto, Michele; Ghio, Stefano; Agostoni, Piergiuseppe; Ameri, Pietro; Argiento, Paola; Daniele Brunetti, Natale; Casamassima, Vito; Casu, Gavino; Cedrone, Nadia; Confalonieri, Marco; Corda, Marco; Correale, Michele; D'Agostino, Carlo; De Michele, Lucrezia; Famoso, Giulia; Galgano, Giuseppe; Greco, Alessandra; Mario Lombardi, Carlo; Manzi, Giovanna; Madonna, Rosalinda; Mercurio, Valentina; Mulè, Massimiliano; Paciocco, Giuseppe; Romaniello, Antonella; Romeo, Emanuele; Scelsi, Laura; Serra, Walter; Stolfo, Davide; Toma, Matteo; Vatrano, Marco; Vitulo, Patrizio; Geri, Pietro; Confalonieri, Paola; Dario Vizza, Carmin

Corpus callosum abnormalities: neuroimaging, cytogenetics and clinical characterization of a very large multicenter Italian series

Corpus callosum abnormalities (CCA) have an estimated prevalence ranging from 0.3% up to 0.7% in patients undergoing brain imaging. CCA can be identified incidentally, or can be part of a developmental disease. We performed a retrospective study of 551 patients, identified non-syndromic (NS) CCA and syndromic (S) CCA, reviewing clinical features, neuroradiological aspects, genetic etiology, and chromosomal microarray (CMA) results. Syndromic CCA subjects were prevalent (60%) and they showed the most severe clinical features. Cortical malformations and cerebellar anomalies were 23% of cerebral malformation associated to CCA (plus), 23 and 14% respectively in syndromic forms. A clinical and/or genetic diagnosis was obtained in 37% of syndromic CCA including chromosomal rearrangements on high-resolution karyotype (18%), microdeletion/microduplication syndromes (31%) and monogenic diseases (51%). Non-syndromic CCA anomalies had mildest clinical features, although intellectual disability was present in 49% of cases and epilepsy in 13%. CMA diagnostic rate in our cohort of patients ranged from 11 to 23% (NS to S). A high percentage of patients (76% 422/551) remain without a diagnosis. Combined high resolution CMA studies and next-generation sequencing (NGS) strategies will increase the probability to identify new causative genes of CCA and to redefine genotype–phenotype correlation

Diabetes Affects Antibody Response to SARS-CoV-2 Vaccination in Older Residents of Long-term Care Facilities: Data From the GeroCovid Vax Study

Objective: Type 2 diabetes may affect the humoral immune response after vaccination, but data concerning coronavirus disease 19 (COVID-19) vaccines are scarce. We evaluated the impact of diabetes on antibody response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in older residents of long-term care facilities (LTCFs) and tested for differences according to antidiabetic treatment. Research design and methods: For this analysis, 555 older residents of LTCFs participating in the GeroCovid Vax study were included. SARS-CoV-2 trimeric S immunoglobulin G (anti-S IgG) concentrations using chemiluminescent assays were tested before the first dose and after 2 and 6 months. The impact of diabetes on anti-S IgG levels was evaluated using linear mixed models, which included the interaction between time and presence of diabetes. A second model also considered diabetes treatment: no insulin therapy (including dietary only or use of oral antidiabetic agents) and insulin therapy (alone or in combination with oral antidiabetic agents). Results: The mean age of the sample was 82.1 years, 68.1% were women, and 25.2% had diabetes. In linear mixed models, presence of diabetes was associated with lower anti-S IgG levels at 2 (β = -0.20; 95% CI -0.34, -0.06) and 6 months (β = -0.22; 95% CI -0.37, -0.07) after the first vaccine dose. Compared with those without diabetes, residents with diabetes not using insulin had lower IgG levels at 2- and 6-month assessments (β = -0.24; 95% CI -0.43, -0.05 and β = -0.30; 95% CI -0.50, -0.10, respectively), whereas no differences were observed for those using insulin. Conclusions: Older residents of LTCFs with diabetes tended to have weaker antibody response to COVID-19 vaccination. Insulin treatment might buffer this effect and establish humoral immunity similar to that in individuals without diabetes