BEYOND WAIST CIRCUMFERENCE IN AN ADULT MALE POPULATION OF SOUTHERN ITALY: IS THERE ANY ROLE FOR SUBSCAPULAR SKINFOLD THICKNESS IN THE RELATIONSHIP BETWEEN INSULIN-LIKE GROWTH FACTOR-1 SYSTEM AND METABOLIC PARAMETERS ?

ABSTRACT Background: Apart from waist circumference, other adiposity measures, such as subscapular skin fold (SST), arouse growing interest due to their relationship to metabolic complications and cardiovascular risk. The Insulin-like Growth Factor (IGF)-1 system is deregulated in obese subjects in proportion to their degree of visceral adiposity. Aim : To examine the association among IGF-1, IGF-Binding Protein (BP)1 and 3 levels and different measures of adiposity in a sample of adult male population in Southern Italy. Materials and Methods: A complete database for this analysis was available for 229 (age range 50–82 years) participating at 2002-2004 Olivetti Heart Study follow-up. Results: After adjustment for age, IGF-1 was inversely associated with BMI and waist circumference (p<0.05). IGFBP1 was inversely associated with BMI, waist circumference, SST, Homeostasis Model Assessment (HOMA) index, Fat Mass (FM). HOMA index, age and SST significantly predicted the IGFBP1 plasma levels, with 24% of IGFPB-1 variability explained at a linear regression analysis. Conclusions: IGFBP1 inversely correlated to adiposity and HOMA index. Among adiposity indexes, SST was the best predictor of IGFPB-1 levels. The evaluation of some components of the IGFs system, and simple measures of body adiposity, such as SST, may represent a further tool to better evidence phenotype profiles associated to the pathogenetic mechanism of cardiovascular risk factor clustering in male adults

Persistent post-traumatic headache: A migrainous loop or not? The clinical evidence

Background: Headache is a common complication of traumatic brain injury. The International Headache Society defines post-traumatic headache as a secondary headache attributed to trauma or injury to the head that develops within seven days following trauma. Acute post-traumatic headache resolves after 3 months, but persistent post-traumatic headache usually lasts much longer and accounts for 4% of all secondary headache disorders. Main body: The clinical features of post-traumatic headache after traumatic brain injury resemble various types of primary headaches and the most frequent are migraine-like or tension-type-like phenotypes. The neuroimaging studies that have compared persistent post-traumatic headache and migraine found different structural and functional brain changes, although migraine and post-traumatic headache may be clinically similar. Therapy of various clinical phenotypes of post-traumatic headache almost entirely mirrors the therapy of the corresponding primary headache and are currently based on expert opinion rather than scientific evidence. Pharmacologic therapies include both abortive and prophylactic agents with prophylaxis targeting comorbidities, especially impaired sleep and post-traumatic disorder. There are also effective options for non-pharmacologic therapy of post-traumatic headache, including cognitive-behavioral approaches, onabotulinum toxin injections, life-style considerations, etc. Conclusion: Notwithstanding some phenotypic similarities, persistent post-traumatic headache after traumatic brain injury, is considered a separate phenomenon from migraine but available data is inconclusive. High-quality studies are further required to investigate the pathophysiological mechanisms of this secondary headache, in order to identify new targets for treatment and to prevent disability

Analisi pre-restauro e conservazione di reperti lignei dell’imbarcazione romana rinvenuta presso la baia di Scauri (Pantelleria)

Il volume, oltre ad essere un compendio tecnico-scientifico, illustra la sintesi dell’imponente e significativo lavoro svolto dalle strutture competenti e dagli specialisti che si sono succeduti nell’ultimo decennio nello scavo archeologico subacqueo del relitto tardo-antico di Scauri a Pantelleria. In particolare il contributo si occupa delle analisi pre-restauro effettuate su elementi o parti strutturali pertinenti all'imbarcazione stessa per individuare lo stato di degrado del legno e la conseguente metodologia di restauro da utilizzare

Recommending salt intake reduction to the hypertensive patient: More than just lip service

The average individual dietary salt intake largely exceeds the physiological needs almost worldwide. A direct causal association between salt intake and blood pressure levels has been clearly established. Furthermore, there is increasing evidence for additional blood pressure-independent pathways linking excess salt intake to the process of atherosclerosis. Recent meta-analyses of randomized controlled trials showed that moderate reduction of salt intake is associated with reduction of blood pressure and, in perspective, with reduction of cardiovascular and cerebrovascular events in hypertensive individuals. According to the European Society of HypertensionEuropean Society of Cardiology (ESHESC) guidelines for the management of hypertension, instructions to reduce dietary salt intake to the level of 5gday based on the WHO recommendation should be provided to all patients, regardless of their requirement for drug treatment. Unfortunately, the patients response to this measure is heterogeneous, mainly due to variable compliance with the doctors prescription and to a lesser extent to different individual BP salt sensitivity.This article discusses the factors affecting the probability of a successful intervention focusing in particular on the doctors commitment to evaluate the patients dietary habits, to point out the main sources of salt in the patients diet, to provide the patient with adequate motivation and with proper instructions to implement gradual reduction of hisher salt intake, not disregarding the need for regular follow-up

Magnetic resonance imaging enhancement using prior knowledge and a denoising scheme that combines total variation and histogram matching techniques

Introduction: Brain perfusion-weighted images obtained through dynamic contrast studies play a critical and clinical role in diagnosis and treatment decisions. However, due to the patient's limited exposure to radiation, computed magnetic resonance imaging (MRI) suffers from low contrast-to-noise ratios (CNRs). Denoising MRI images is a critical task in many e-health applications for disease detection. The challenge in this research field is to define novel algorithms and strategies capable of improving accuracy and performance in terms of image vision quality and computational cost to process data. Using MRI statistical information, the authors present a method for improving image quality by combining a total variation-based denoising algorithm with histogram matching (HM) techniques. Methods: The total variation is the Rudin–Osher–Fatemi total variation (TV-ROF) minimization approach, TV-L2, using the isotropic TV setting for the bounded variation (BV) component. The dual-stage approach is tested against two implementations of the TV-L2: the split Bregman (SB) algorithm and a fixed-point (FP) iterations scheme. In terms of HM, the study explores approximate matching and the exact histogram matching from Coltuc. Results: As measured by the structural similarity index (SIMM), the results indicate that in the more realistic study scenarios, the FP with an HM pairing is one of the best options, with an improvement of up to 12.2% over the one without an HM. Discussion: The findings can be used to evaluate and investigate more advanced machine learning-based approaches for developing novel denoising algorithms that infer information from ad hoc MRI histograms. The proposed methods are adapted to medical image denoising since they account for the preference of the medical expert: a single parameter can be used to balance the preservation of (expert-dependent) relevant details against the degree of noise reduction

Post COVID-19 vaccination headache: A clinical and epidemiological evaluation

INTRODUCTION: This study aimed to assess the prevalence and clinical characteristics of headaches, in particular secondary headaches. MATERIALS AND METHODS: This observational study was performed at the ASST Spedali Civili of Brescia, Italy. Visits to the Emergency Department (ED) and subsequent hospitalizations regarding a new or worsening headache in the 16 days following the administration of the COVID-19 vaccine between January 2021 and January 2022 were recorded and compared with those of January 2019-January 2020. RESULTS: The ratio between ED admissions due to headaches and total ED admissions was significantly higher in 2021 compared with 2019 (4.84% vs. 4.27%; p < 0.0001). Two-hundred and eighty-nine ED headache admissions (10.8% of all ED headache admissions) were time-correlated to the COVID-19 vaccination, of which 40 were hospitalized in order to exclude a symptomatic etiology. At discharge, 32 patients had a diagnosis of benign headache not attributed to any cranial/extracranial disorder and eight patients of secondary headache, whose diagnoses were the following: Headache attributed to cranial and/or cervical vascular disorder (n = 4); headache attributed to nonvascular intracranial disorder (n = 2); headache or facial pain attributed to disorder of the cranium, neck, eyes, ears, nose, sinuses, teeth, mouth, or other facial or cervical structure (n = 1); and painful lesions of the cranial nerves (n = 1). The headache most frequently reported by patients had migraine-like characteristics: the localization was predominantly frontal or temporal, the pain was described as throbbing and severe in intensity and it was frequently accompanied by nausea/vomit, and photo-phonophobia. Over half-regardless of the final diagnosis-of hospitalized patients had a history of primary headaches. CONCLUSIONS: Following the spread of COVID-19 vaccination, the number of ED admissions due to headaches significantly increased. However, less than 14% of all the ED visits due to a headache time-correlated to the COVID-19 vaccination were actually hospitalized, with most patients documenting a benign headache, possibly related to the generic side effects of the vaccination. Only 8/40 hospitalized patients were diagnosed with a secondary headache. These benign headaches would actually fulfill diagnostic criteria for 8.1 Headaches attributed to the use of or exposure to a substance (ICHD-3), although, at the time being, it does not include vaccines as possible substances.The headache migraine-like characteristics' reported by most patients could suggest activation of the trigeminovascular pathway by all the cytokines and other pro-inflammatory molecules released following the vaccination

EFFECT OF DIETARY SODIUM INTAKE ON URINARY ALBUMIN EXCRETION: A META-ANALYSIS OF INTERVENTION STUDIES

Studio di metaanalis

Effetto del consumo di sale sulla escrezione urinaria di albumina: meta-analisi degli studi di intervento

Presentazione di uno studio di metaanalis

Intersection of exogenous, endogenous and anthropogenic factors in the Holocene landscape: A study of the Naples coastline during the last 6000 years

New data on the ancient landscape of Naples (southern Italy) during the middle and late Holocene from geo-archaeological excavations were used to reconstruct the hill and coastal environment to the west of the ancient Graeco-Roman polis. Between the 5th and 4th millennia BP, a rocky profile with a wave-cut platform cutting across pyroclastites emplaced from the surrounding volcanoes was predominant in the coastal landscape. During the 3rd millennium BP, this rocky coast was progressively replaced by a sandy littoral environment primarily due to marine deposition, with a coastline located some hundred meters inland with respect to the modern one. The sedimentary record of the Greek and Roman periods indicates short-term fluctuations of the coastline, leading to the establishment of a backshore environment towards the end of the 6th century AD, when prograding river mouths and lobes of debris flows contributed to the advancing trend of the shoreline. The frequent archaeological remains from these periods indicate a stable settled area since Roman times. The shoreline was still subject to short-lived fluctuations between the 12th and 16th centuries, and attained its present position during the modern era with man-made reshaping of its profile. The construction of Relative Sea Level curves for two coastal sites reveals that the persistence of the foreshore environment in the Naples coastal strip during the 5th and 4th millennia BP was controlled by the counterbalancing effect of either the concurrent eustatic sea level rise or subsidence. On the other hand, the morpho-stratigraphic record for the last two millennia shows a significant correlation between sedimentation rate and settlement history, accounting for the dominant role of the anthropogenic forcing-factor in late Holocene landscape history. In particular, land mismanagement during Late Antiquity seems to have triggered a slope disequilibrium phase, exacerbating soil erosion and increasing the sediment accumulation rate in both foothill and coastal areas. Nonetheless, the environmental changes of the Chiaia coast during the last 2000 years clearly show volcanotectonic perturbations influencing coastline development up to the modern era