Identification of dangerous fibers: some examples in Northern Italy

The presence of asbestiform minerals has to be foreseen in the planning of infrastructural activities: Asbestos can be a component of sedimentary rocks or of mafic and ultra mafic metamorphic rocks. Surveys and core drilling, in addition to providing important information on the quality of the rock and its geotechnical characteristics, allow for a prediction of the presence of asbestiform minerals in the areas affected by mining or infrastructural activities. During the excavation, workers can be exposed to the asbestos risk, therefore, the control of the air quality and of the excavated materials are fundamental for the safety of involved people. In this work some problems we met in the analysis of airborne filters and bulk samples from sites in northern Italy are presented. The asbestos fibers present in rocks as accessory minerals, are often different in habit and dimension from the well-known asbestos fibers used as industrial minerals and moreover can be erroneously identified as minerals morphologically and chemically similar present in the same rock or environment. In the case of tunnel muck it could be contaminated by substances used for the excavation that could modify colours and optical properties of asbestos minerals. In the PCOM (Phase Contrast Optical Microscope) analysis chrysotile, sepiolite and antigorite, due to their different refraction index, when the fibers have dimension > 0,5 micron and aren’t contaminated by lubricant can be easely identified even if the morphology of chrysotile is very similar to that of sepiolite. In Electron Scanning Microscope (SEM) the discrimination between chrysotile and antigorite on the airborne filters is not always possible because the fibers of thin dimensions show similar habit and spectrum. In the case of the tremolite amphibole, morphology changes from prismatic to fibrous depending on its origin (p.eg. Monastero, Val Grana, Verrayes, Brachiello). Both prismatic and asbestiform tremolite (Gamble and Gibbs, 2007; Addison and McConnel, 2007) may show inhalable elements with width less than 3 micron, length more than 5 micron and width length ratio 1:3, whose dangerousness (fiber coming from fibrous tremolite or the cleavage fragments coming from prismatic tremolite) could be different and it is object of epidemiologic studies

Ketonemia variability through menstrual cycle in patients undergoing classic ketogenic diet

IntroductionKetogenic dietary therapies (KDT) are well-established, safe, non-pharmacologic treatments used for children and adults with drug-resistant epilepsy and other neurological disorders. Ketone bodies (KBs) levels are recognized as helpful to check compliance to the KDT and to attempt titration of the diet according to the individualized needs. KBs might undergo inter-individual and intra-individual variability and can be affected by several factors. Possible variations in glycemia and ketone bodies blood levels according to the menstrual cycle have not been systematically assessed yet, but this time window deserves special attention because of hormonal and metabolic related changes.MethodsThis study aims at searching for subtle changes in KBs blood level during menstrual cycle in female patients undergoing a stable ketogenic diet, by analyzing 3-months daily measurement of ketone bodies blood levels and glucose blood levels throughout the menstrual cycle.ResultsWe report the preliminary results on six female patients affected by GLUT1DS or drug resistant epilepsy, undergoing a stable classic ketogenic diet. A significant increase in glucose blood levels during menstruation was found in the entire cohort. As far as the ketone bodies blood levels, an inversely proportional trend compared to glycemia was noted.ConclusionExploring whether ketonemia variations might occur according to the menstrual cycle is relevant to determine the feasibility of transient preventive diet adjustments to assure a continuative treatment efficacy and to enhance dietary behavior support.Clinical trial registrationclinicaltrials.gov, identifier NCT05234411

Ketogenic dietary therapies in epilepsy: recommendations of the Italian League against Epilepsy Dietary Therapy Study Group

A stepwise increase in the utilization of ketogenic dietary therapies for drug-resistant epilepsy has been observed in Italy in the last decade, although it is still considered often underused in many centers when compared to other countries. The Dietary Therapy Study Group of the Italian League against Epilepsy proposes practical recommendations to improve shared knowledge and facilitate the application of ketogenic dietary therapies, optimizing its efficacy and tolerability. The experts involved (11 child neuropsychiatrists, two adult neurologists, one psychologist, one pharmacologist, one pediatric endocrinologist, one representative of patients' associations, and three dietitians and clinical nutritionists) responded to a survey on current clinical practice issues and were asked to discuss controversial topics related to supplementation, long-term maintenance, transition, and a multidisciplinary approach to ketogenic dietary therapies. Practical indications for patient selection, diet initiation, management, side effects prevention, and follow-up are provided

Short-term effects of ketogenic diet on anthropometric parameters, body fat distribution, and inflammatory cytokine production in GLUT1 deficiency syndrome

Objective: The aim of this study was to evaluate the effects of a 12-wk ketogenic diet (KD) on inflammatory status, adipose tissue activity biomarkers, and abdominal visceral (VAT) and subcutaneous fat (SAT) in children affected by glucose transporter 1 deficiency syndrome GLUT1 DS. Methods: We carried out a short-term longitudinal study on 10 children (mean age: 8.4 y, range 3.3–12 y, 5 girls, 5 boys) to determine fasting serum proinflammatory cytokines (high sensitivity C-reactive protein, tumor necrosis factor-a interleukin-6), adipocyte-derived chemokines (leptin and adiponectin), lipid profile, homeostatic model assessment-insulin resistance (HOMA-IR), quantitative insulin sensitivity index (QUICKI), anthropometric measurements, and VAT and SAT (by ultrasonography). Results: Children showed no significant changes in inflammatory and adipose tissue activity biomarkers, blood glucose, lipid profile, anthropometric measurements, VAT, and SAT. Fasting insulin decreased (6 3.2 mU/mL versus 3 2 mU/mL; P ¼ 0.001), and both HOMA-IR and QUICKI indexes were significantly modified (1.2 0.6 versus 0.6 0.4; P ¼ 0.002; 0.38 0.03 versus 0.44 0.05; P ¼ 0.002, respectively). Conclusions: Only HOMA-IR and QUICKI indexes changed after 12 wk on a KD, suggesting that over a short period of time KD does not affect inflammatory cytokines production and abdominal fat distribution despite being a high-fat diet. Long-term studies are needed to provide answers concerning adaptive metabolic changes during K

Ketonemia variability through menstrual cycle in patients undergoing classic ketogenic diet

Introduction: Ketogenic dietary therapies (KDT) are well-established, safe, non-pharmacologic treatments used for children and adults with drug-resistant epilepsy and other neurological disorders. Ketone bodies (KBs) levels are recognized as helpful to check compliance to the KDT and to attempt titration of the diet according to the individualized needs. KBs might undergo inter-individual and intra-individual variability and can be affected by several factors. Possible variations in glycemia and ketone bodies blood levels according to the menstrual cycle have not been systematically assessed yet, but this time window deserves special attention because of hormonal and metabolic related changes. Methods: This study aims at searching for subtle changes in KBs blood level during menstrual cycle in female patients undergoing a stable ketogenic diet, by analyzing 3-months daily measurement of ketone bodies blood levels and glucose blood levels throughout the menstrual cycle. Results: We report the preliminary results on six female patients affected by GLUT1DS or drug resistant epilepsy, undergoing a stable classic ketogenic diet. A significant increase in glucose blood levels during menstruation was found in the entire cohort. As far as the ketone bodies blood levels, an inversely proportional trend compared to glycemia was noted. Conclusion: Exploring whether ketonemia variations might occur according to the menstrual cycle is relevant to determine the feasibility of transient preventive diet adjustments to assure a continuative treatment efficacy and to enhance dietary behavior support. Clinical trial registration: clinicaltrials.gov, identifier NCT05234411