Former heroin-dependent alcohol use disorder patients. prevalence, addiction history and clinical features

Aims: To examine the prevalence of former heroin dependence (FHA) in Alcohol Use Disorder (AUD) patients; to compare the clinical characteristics of FHA-AUD patients versus AUD patients without any past use of heroin at alcohol treatment entry; to document the heroin dependence history of FHA-AUD patients, and review treatment strategies for this group. Methods: Retrospective case review of 448 consecutive AUD patients. Results: The annual entry of FHA-AUD showed stability over the study period of 3 years overall 60/ 448 (13.3%). FHA-AUD patients showed higher concomitant use of cocaine, benzodiazepines, cannabis and hallucinogens than other heroin addicts. They consumed higher amounts of alcohol at the beginning of their alcohol dependence history, and reached a high maximum level of alcohol consumption, than other AUD patients, and tended to have more physical disorders. The most important signals of FHA-AUD were polyabuse and older age at the time of presentation. FHA-AUD patients tended to have had a severe pattern of heroin dependence associated with inadequate agonist opiate treatment. Conclusions: The prevalence of FHA-AUD patients is not negligible. This may relate to previous inadequate treatment of heroin addiction contributing to the development of severe AUD. For these patients we propose a reconsideration of ‘soft’ (low dose) agonist opiate treatment

Impact of glucose dosing regimens on modeling of glucose tolerance and β-cell function by intravenous glucose tolerance test in diet-induced obese mice.

Insulin sensitivity declines in overweight and obese individuals and, under normal conditions, insulin secretion adaptively increases which in healthy non-diabetic subjects maintains normal glycemia. This adaptation is best described by the disposition index derived from modeling of insulin and glucose data from an intravenous glucose tolerance testing (IVGTT). One caveat of the IVGTT is that basing the glucose dose on the individual total body weight can result in large differences in the amount of glucose given to lean and obese individuals. The effect this has on determination of insulin sensitivity and β-cell function is unknown. In this study, we therefore evaluated alternative glucose dosing regimens for determination of the impact of glucose dosing on measures of β-cell function in normal and diet-induced obese (DIO) mice. The glucose dosing regimens used for the IVGTT were 0.35 mg per kg total body weight (BW) or per kg lean BW or a fixed glucose dose based on the average BW for all experimental mice. Each regimen detected a similar decrease in insulin sensitivity in DIO mice. The different glucose dosing regimens gave, however, diverging results in regard to glucose elimination and the acute insulin response. Thus, the fixed-dose regimen was the only that revealed impairment of glucose elimination, whereas dosing according to total BW was the only regimen which showed significant increases in acute insulin response in DIO mice. The fixed-dose glucose dosing regimen was the only that revealed a significant decline in the disposition index value in DIO mice, which is characteristic of type 2 diabetes in humans. Our results therefore show that using different glucose dosing regimens during IVGTT in DIO mice one can model different aspects of physiology which are similar to prediabetes and type 2 diabetes in humans, with the fixed-dose regimen producing a phenotype that most closely resembles human type 2 diabetes

Differential Development of Glucose Intolerance and Pancreatic Islet Adaptation in Multiple Diet Induced Obesity Models

Background: The C57BL/6 mouse fed a high fat diet is a common and valuable model in experimental studies of obesity and type 2 diabetes (T2D). Different high fat diets are used and in order to determine which diet produces a model most accurately resembling human T2D, they need to be compared head-to-head. Methods: Four different diets, the 60% high fat diet (HFD) and the 58% high fat-high sucrose Surwit diet (HFHS) and their respective controls, were compared in C57BL/6J mice using glucose tolerance tests (IVGTT) and the euglycemic clamp. Results: Mice fed a HFD gained more weight than HFHS fed mice despite having similar energy intake. Both high fat diet models were glucose intolerant after eight weeks. Mice fed the HFD had elevated basal insulin, which was not seen in the HFHS group. The acute insulin response (AIR) was unchanged in the HFD group, but slightly increased in the HFHS diet group. The HFHS diet group had a threefold greater total insulin secretion during the IVGTT compared to its control, while no differences were seen in the HFD group. Insulin sensitivity was decreased fourfold in the HFD group, but not in the HFHS diet group. Conclusion: The HFD and HFHS diet models show differential effects on the development of insulin resistance and beta cell adaptation. These discrepancies are important to acknowledge in order to select the appropriate diet for specific studies

La nuova geoeconomia mondiale. Alla ricerca di una risposta italiana

La mappa della geoeconomia mondiale - a metà anni novanta - con una lettura geoeconomica della competizione globale e la collocazione geopolitica dell'Italia: orientamenti per il nostro Paese e le sue principali aree, anche con riferimento al contesto europeo.- Indice #9- Premessa, Marcello Pacini #11- Cap.I Una lettura geoeconomica della competizione globale #15- Cap.II Un orientamento geoeconomico per l’Italia #25- Cap.III La nuova mappa mentale della geoeconomia mondiale #39- Conclusioni #53- Appendice I #55- Accordi di integrazione regionale notificati al Gatt-Wto, al 31 gennaio 1995 #57- Nafta (North American Free Trade Agreement) #59- Mercosur (Mercato Común del Sur) #61- Commercio intra-asiatico #63- Asean (Association of South East Asian Nations)-Afta (Asean Free Trade Area) #67- Srez (Sub regional economie zones) #71- Apec (Asia Pacific Economie Cooperation) #73- Eaec (East Asian Economic Caucus) #77- I fondamenti culturali del modello di sviluppo asiatico e la questione dei diritti umani #79- Appendice II Grafici e cartine #8

Gli arabi nelle Gallie, o sia il trionfo della fide [Texto impreso] : melodramma serio in due atti = Los árabes en las Galias, o sea el triunfo de la fe : melodrama serio en dos actos

Libreto de la ópera de Giovanni Pacini en italiano y castellan

Insulin resistance as a determinant of platelet activation in obese women

OBJECTIVES We tested the hypothesis that insulin resistance, per se, contributes to increased platelet activation in obesity, independently of underlying inflammation. BACKGROUND Obesity, insulin resistance, and atherosclerosis are closely linked phenomena associated with low-grade inflammation. Obesity is associated with persistent platelet activation in otherwise healthy women. METHODS We performed a cross-sectional study in 40 obese and 20 non-obese healthy women using urinary thromboxane metabolite excretion as a non-invasive index of platelet activation. An index of insulin sensitivity, S, and plasma adiponectin, C-reactive protein (CRP), and CD40 ligand (CD40L) levels were measured. RESULTS Obese women had significantly (p < 0.0001) higher 11-dehydro-thromboxane B-2 (11-dehydro-TXB2) excretion (median 718 vs. 211 pg/mg creatinine), CRP (1.13 vs. 0.48 mg/1), and CD40L levels (4.45 vs. 0.90 ng/ml) than controls. Obese women had lower S, (median 2.51 vs. 5.0 10(4) min(-1)/[mu U/ml], p < 0.002) and adiponectin (6.3 vs. 10 mu g/ml, p < 0.01) than control subjects. On multiple regression analysis, waist-to-hip ratio (beta = 0.27, p < 0.05) and S, (beta = -0.72, p < 0.04) predicted 11-dehydro-TXB2 excretion rate, independently of adiponectin, CRP, CD40L, and lipid patterns. In order to investigate the cause-effect relationship of these associations, we examined the effects of a 12-week weight loss program or a 3-week pioglitazone treatment on urinary 11-dehydro-TXB2 in 10 women with impaired S-1 and visceral obesity. Successful weight loss (0.6 kg loss/week) achieved in 5 subjects was associated with increased S-1 (+92%) and decreased CD40L (-27%), CRP (-37%), and 11-dehydro-TXB2 (-53%) (p < 0.05). Consistently, improvement of insulin sensitivity achieved with pioglitazone significantly decreased urinary 11-dehydro-TXB2 excretion (-43%, p < 0.05) without changes in body weight. CONCLUSIONS Insulin resistance is a major determinant of platelet activation in female obesity

Mathematical Model of Glucagon Kinetics for the Assessment of Insulin-Mediated Glucagon Inhibition During an Oral Glucose Tolerance Test

none6siGlucagon is secreted from the pancreatic alpha cells and plays an important role in the maintenance of glucose homeostasis, by interacting with insulin. The plasma glucose levels determine whether glucagon secretion or insulin secretion is activated or inhibited. Despite its relevance, some aspects of glucagon secretion and kinetics remain unclear. To gain insight into this, we aimed to develop a mathematical model of the glucagon kinetics during an oral glucose tolerance test, which is sufficiently simple to be used in the clinical practice. The proposed model included two first-order differential equations -one describing glucagon and the other describing C-peptide in a compartment remote from plasma - and yielded a parameter of possible clinical relevance (i.e., SGLUCA(t), glucagon-inhibition sensitivity to glucose-induced insulin secretion). Model was validated on mean glucagon data derived from the scientific literature, yielding values for SGLUCA(t) ranging from -15.03 to 2.75 (ng of glucagon·nmol of C-peptide-1). A further validation on a total of 100 virtual subjects provided reliable results (mean residuals between -1.5 and 1.5 ng·L-1) and a negative significant linear correlation (r = -0.74, p < 0.0001, 95% CI: -0.82 - -0.64) between SGLUCA(t) and the ratio between the areas under the curve of suprabasal remote C-peptide and glucagon. Model reliability was also proven by the ability to capture different patterns in glucagon kinetics. In conclusion, the proposed model reliably reproduces glucagon kinetics and is characterized by sufficient simplicity to be possibly used in the clinical practice, for the estimation in the single individual of some glucagon-related parameters.openMorettini, Micaela; Burattini, Laura; Göbl, Christian; Pacini, Giovanni; Ahrén, Bo; Tura, AndreaMorettini, Micaela; Burattini, Laura; Göbl, Christian; Pacini, Giovanni; Ahrén, Bo; Tura, Andre

Italy. A country shaped by man

Catalogo, in inglese, del Programma "Italy. A country shaped by man" costituito da varie mostre, rassegne, incontri e una multivisione volta a promuovere l'immagine dell'Italia all'estero.- Why "Italy. A country shaped by man"? , Marcello Pacini #11- Italy through the camera's eye, Giovanni Chiaramonte #85- Another face of Italian art, Giuliano Briganti #11

Assessment of management of a golf course by means of sustainability indicators

Golf courses are supposed to produce remarkable negative effects on the environment, due to some techniques involved in their management. To provide data useful for the proper assessment of the agro-environmental sustainability of a golf course, the framework agro-environmental sustainability information system (AESIS) was used, utilizing a set of indicators suitable to evaluate different dimensions of sustainability (physical, ecological, productive and social). The management of areal golf course located in Tuscany (central Italy) was compared to an alternative land use of the same area represented by an ordinary farm based on a sunflower-wheat rotation. Assessment indicators were selected by applying a conceptual model based on ecology theory and were calculated considering site-specific production and pedo-climatic features of the area. Different weighting scenarios were hypothesized in order to have different management options assessed and to carry out a targeted sensitivity analysis. Main results confirmed the significant impact of golf management on some ecological characteristics but the holistic assessment of AESIS approach permitted an overall evaluation that comprised a wide range of different issues. AESIS demonstrated to be a practical and adaptive tool able to perform an efficient comparison of possible land destinations