An eigenvalue problem for the anisotropic Φ\Phi-Laplacian

We study an eigenvalue problem involving a fully anisotropic elliptic differential operator in arbitrary Orlicz-Sobolev spaces. The relevant equations are associated with constrained minimization problems for integral functionals depending on the gradient of competing functions through general anisotropic $N$-functions. In particular, the latter need neither be radial, nor have a polynomial growth, and are not even assumed to satisfy the so called $\Delta_2$-condition. The resulting analysis requires the development of some new aspects of the theory of anisotropic Orlicz-Sobolev spaces

Nordic walking increases circulating VEGF more than traditional walking training in postmenopause.

OBJECTIVES Nordic walking (NW) is widely practiced by postmenopausal women. Its effects are peculiar owing to the involvement of more muscle groups than in traditional walking training (WT). Since mechanical load promotes secretion of vascular endothelial growth factor (VEGF) from both skeletal muscle and muscle endothelium, the aim of the study was to compare the effect of NW and WT on VEGF levels. METHOD Thirty postmenopausal women were randomly assigned to NW or WT. Both groups trained 40-50 min/day, three times per week, at a mean intensity of 12 on a 15-category scale of the ratings of perceived exertion. Since VEGF is also released from adipocytes, anthropometric parameters were assessed. RESULTS NW increased circulating VEGF more than WT (p = 0.041). Furthermore, both study groups exhibited an average decrease in weight (p = 0.023), body mass index (p = 0.024), hip circumference (p = 0.001), and arm fat index, although WT participants had higher values for this index at baseline (p < 0.001) and thus exhibited a greater net decrease compared with the NW participants (p < 0.011). CONCLUSIONS These data imply that NW increases the level of circulating VEGF more than does traditional walking when the intensity of training is equivalent

Quale analisi cefalometrica per la chirurgia maxillo-mandibolare in pazienti con sindrome delle apnee ostruttive notturne?

L’avanzamento maxillo-mandibolare (AMM) è un trattamento efficace per pazienti affetti da sindrome delle apnee ostruttive notturne (OSAS) di grado severo. Sebbene il miglioramento dell’OSAS sia l’obiettivo principale di tale chirurgia, è necessario evitare un avanzamento maxillo-mandibolare eccessivo per garantire un gradevole risultato in termini di estetica facciale. A tale scopo, è necessario programmare preoperatoriamente l’entità dell’AMM mediante un’analisi estetica e cefalometrica. Le analisi cefalometriche di Steiner e Delaire vengono comunemente impiegate nella programmazione della chirurgia ortognatica per deformità dentofaciali, tuttavia resta controverso il ruolo di tali analisi nei pazienti con OSAS candidati a AMM. Quarantotto pazienti con OSAS severa sono stati sottoposti a AMM. Abbiamo effettuato le analisi cefalometriche di Steiner e Delaire in tutti i soggetti. Per il tracciato di Steiner, abbiamo misurato la variazione degli angoli SNA e SNB, mentre per l’analisi di Delaire, abbiamo misurato la variazione degli angoli C3/FM-CPA e C3/ FM-Me. L’AMM medio è stato di 6,9 + 3,8 mm per il mascellare superiore e 13,6 + 5 mm per la mandibola. Dopo l’intervento abbiamo riscontrato un miglioramento dell’Indice di Apnea-Ipopnea (40,47 + 7,64 preoperatoriamente vs. 12,56 + 5,78 postoperatoriamente). In tutti i pazienti, entrambe le tecniche cefalometriche hanno dimostrato una retrusione bimascellare preoperatoria. Dopo l’intervento, l’angolo SNA medio è aumentato da 78,18° a 85,58° (p < 0,001), mentre l’angolo C3/FM-CPA medio è aumentato da 81,19° a 89,71° (p < 0,001). Il valore medio dell’angolo SNB è aumentato da 74,33° a 80,73° (p < 0,001), mentre l’angolo medio C3/FM-CPA è passato da 80,10° a 87,29° (p < 0,001). Postoperatoriamente, sia il mascellare superiore che la mandibola risultavano in una posizione più protrusa (p < 0,001) se analizzati secondo l’analisi di Steiner rispetto al tracciato di Delaire. L’utilizzo dell’analisi cefalometrica di Delaire nella programmazione dell’AMM in pazienti con OSAS comporta un avanzamento maxillo-mandibolare superiore rispetto al tracciato di Steiner. È opportuno considerare le conseguenze di tale risulto sull’estetica facciale durante la programmazione chirurgica e nel consenso informato preoperatorio in pazienti con OSAS candidati a AMM

Midline mandibular osteotomy in an asymmetric patient.

Abstract This case report shows the possibility of the application of a mandibular osteotomy to resolve mandibular asymmetry with independent and discordant movements of both bony segments. The authors report the case of a 25-year-old woman referred for mandibular asymmetry, with a transverse excess of the right hemi mandible and vertical defect of the left one. The patient underwent a bilateral sagittal split osteotomy, midline osteotomy, and genioplasty, which corrected the mandibular asymmetry with contraction of the entire right hemi mandible. A slight left vertical increase was also obtained through the surgically created lateral open bite. In the follow-up assessment, the patient's face appeared symmetrical with normalization of the bizygomatic-bigonial relationships, and the facial shape corresponded to ideal anthropometric features. This technique resulted in resolution of mandibular asymmetry. In addition, mandibular osteotomy permits the esthetic management of the shape of the entire mandibular body in relation to the other third of the face

Pilot Study of a New Mandibular Advancement Device

This study was conducted to determine the efficacy of a customized mandibular advancement device (MAD) in the treatment of obstructive sleep apnea (OSA). Eight patients (M = 3; F = 5; mean age = 56.3 ± 9.4) with a diagnosis of OSA confirmed by polysomnography (PSG) were re-cruited on the basis of the following inclusion criteria: apnea-hypopnea index (AHI) &gt; 5, age between 18 and 75 years, body mass index (BMI) &lt; 25, and PSG data available at baseline (T0). All were treated with the new NOA® MAD by OrthoApnea (NOA® ) for at least 3 months; PSG with NOA in situ was performed after 3 months of treatment (T1). The following parameters were calculated at T0 and T1: AHI, supine AHI, oxygen desaturation index (ODI), percentage of recording time spent with oxygen saturation &lt;90% (SpO2 &lt; 90%), and mean oxygen desaturation (MeanSpO2%). Data were submitted for statistical analysis. The baseline values were AHI = 21.33 ± 14.79, supine AHI = 35.64 ± 12.80, ODI = 17.51 ± 13.5, SpO2 &lt; 90% = 7.82 ± 17.08, and MeanSpO2% = 93.45 ± 1.86. Four patients had mild OSA (5 &gt; AHI &lt; 15), one moderate OSA (15 &gt; AHI &lt; 30), and three severe OSA (AHI &gt; 30). After treatment with NOA®, statistically significant improvements in AHI (8.6 ± 4.21) and supine AHI (11.21 ± 7.26) were recorded. OrthoApnea NOA® could be an effective alternative in the treatment of OSA: the device improved the PSG parameters assessed

Predictors of Postabsorptive Ghrelin Secretion after Intake of Different Macronutrients

Abstract Context: Release of ghrelin, a gastrointestinal hormone regulating feeding and energy balance, is blunted in obesity, a condition associated with insulin resistance. Objective: The objective was to identify anthropometric and metabolic predictors of postabsorptive ghrelin secretion. Design: We evaluated ghrelin, insulin, glucose, and leptin secretion overnight and after intake of different macronutrients. Subjects: Ten obese subjects (age, 31.8 ± 2.5 yr; body mass index, 43.4 ± 0.8 kg/m2) and six lean subjects (age, 33.5 ± 2.4 yr; body mass index, 21.8 ± 1.4 kg/m2) participated in the study. Main Outcome Measures: The main outcome measures were resting energy expenditure (REE); fat mass; nighttime approximate entropy (ApEn) and synchronicity (cross-ApEn) of ghrelin, insulin, and leptin; insulin sensitivity by homeostatic model approach insulin-sensitivity (HOMA-S%); postabsorptive area under the curve (AUC); and Δ of ghrelin, insulin, glucose, and leptin after carbohydrate-, lipid-, and protein-rich test meals. Results: Nighttime ApEn scores were higher in obese than lean subjects (P &lt; 0.01). Cross-ApEn revealed a synchronicity between ghrelin-insulin, ghrelin-leptin, and insulin-leptin in both groups. Compared with baseline, ghrelin decreased significantly (P &lt; 0.01) in lean and obese subjects after carbohydrates (42.2 vs. 28.5%; P &lt; 0.05), lipids (40.2 vs. 26.2%; P &lt; 0.01), and proteins (42.2 vs. 26.3%; P &lt; 0.01) devoid of between-meal ghrelin differences. Significant associations occurred between nocturnal ghrelin ApEn and insulin (r = 0.53; P &lt; 0.05), postmeal ghrelin AUCs and REE (r = −0.57; P &lt; 0.05), and HOMA-S% (r = 0.52; P &lt; 0.05), postmeal ghrelin Δ and HOMA-S% (r = 0.60; P &lt; 0.05). REE (β = −0.57; P = 0.02) and ghrelin ApEn (β = −0.62; P = 0.01) were predictors of postmeal ghrelin AUC and Δ, respectively. Conclusions: Obesity determined a decreased orderliness of ghrelin secretion and a relative loss of ghrelin-insulin synchrony. Postabsorptive ghrelin secretion decreased significantly both in obese and lean subjects, was related to insulin sensitivity, and was predicted by energy expenditure and hormone pulsatility

Okadaic acid-Parthenolide combination at subtoxic doses induces potent synergistic apoptotic effects in human retinoblastoma Y79 cells by upregulating PTEN.

Retinoblastoma is the most common intraocular malignancy afflicting children. The incidence is higher in developing countries, where treatment is limited and long-term survival rates are low. Vincristine, etoposide, and carboplatin -the agents commonly used in the treatment of retinoblastoma- determine side effects causing significant morbidity to pediatric patients and significantly limiting dosing. Thus, identifying new drugs and molecular targets to facilitate the development of novel therapeutics, and finding natural drug combinations to kill cancer cells by synergistically acting at subtoxic doses, may be a good goal. Here, we investigated the effects of two natural compounds, okadaic acid (OKA) and parthenolide (PN), in human retinoblastoma Y79 cells. We showed that OKA/PN combination at subtoxic doses induces potent synergistic apoptotic effects accompanied by decrease in p-Akt, increase in the stabilized p53 forms and potent decrease in pS166\u2013Mdm2. We also showed the key involvement of PTEN which, after OKA/PN treatment, potently increased before p53, suggesting that p53 activation was under PTEN action. PTEN-knockdown increased p-Akt/ pS166Mdm2 over basal levels and significantly lowered p53, while OKA/PN treatment failed both to lower p-Akt and pS166\u2013Mdm2 and to increase p53 below/over their basal levels respectively. OKA/PN treatment potently increased ROS levels while decreased those of GSH. Reducing cellular GSH by butathionine-sulfoximine treatment significantly anticipated the cytotoxic effect exerted by OKA/PN. The effects of OKA/PN treatment on both GSH content and cell viability were less pronounced in PTEN silenced cells than in control cells. Our study reports for the first time both a synergistic apoptotic action between OKA and PN and the involvement of PTEN as key player in the apoptotic mechanism in human retinoblastoma Y79 cells. The results provide strong suggestion for combined inhibition of the PTEN/Akt/Mdm2/p53 pathway