212 research outputs found
Early Expression of Pro- and Anti-Inflammatory Cytokines in Left Ventricular Assist Device Recipients With Multiple Organ Failure Syndrome
To assess whether the combined evaluation of total Sequential Organ Failure Assessment (t-SOFA) score and pro- and anti-inflammatory cytokine profiles early after left ventricular assist device (LVAD) implant discriminates patients at high risk for multiple organ failure syndrome (MOFS) in the first month post-LVAD
Titratable fixed-ratio combination of insulin glargine plus lixisenatide: A simplified approach to glycemic control in type 2 diabetes mellitus.
Abstract Approximately 50% of patients with type 2 diabetes mellitus (T2DM) do not achieve glycemic targets and require treatment intensification. A fixed-ratio combination of a glucagon-like peptide-1 receptor agonist (GLP-1 RA) with basal insulin, such as lixisenatide with insulin glargine (iGlarLixi), exploits the complementary mechanisms of action of each component to address hyperglycemia while mitigating potential adverse events (AEs). The iGlarLixi dose is titrated considering the effect of basal insulin on fasting plasma glucose, and the fixed-ratio combination ensures that the lixisenatide dose never exceeds 20 μg/day. We describe the characteristics of iGlarLixi therapy, based on the LixiLan clinical program, and provide guidance on the characteristics of patients likely to benefit from such treatment in routine clinical practice. In the phase III LixiLan trials, iGlarLixi resulted in significantly greater reductions in glycated hemoglobin (HbA1c), better achievement of HbA1c targets, less glycemic variability versus insulin glargine, lixisenatide or GLP-1 RA alone, and was associated with weight control, less hypoglycemia versus insulin glargine, and fewer GI AEs versus lixisenatide. Findings were consistent regardless of age, diabetes duration, and baseline HbA1c. The efficacy, safety, and convenient once-daily administration schedule of iGlarLixi make it a valuable treatment option for patients with T2DM requiring treatment intensification
Early Expression of Pro- and Anti-Inflammatory Cytokines in Left Ventricular Assist Device Recipients With Multiple Organ Failure Syndrome
To assess whether the combined evaluation of total Sequential Organ Failure Assessment (t-SOFA) score and pro- and anti-inflammatory cytokine profiles early after left ventricular assist device (LVAD) implant discriminates patients at high risk for multiple organ failure syndrome (MOFS) in the first month post-LVA
At-home Cosmeceutical Application and Outpatient Treatments: A 3D Stepwise Facial Rejuvenation Approach
BACKGROUND: Aging affects the 3-dimensional structure of all the facial tissues: Bones, muscles, ligaments, adipose tissue, and skin.
AIM: To customize minimally invasive treatments for facial rejuvenation, we present a standardized holistic approach characterized by at-home treatments in associations with outpatient procedures.
METHODS: Forty-four patients underwent 3-dimensional stepwise facial rejuvenation and were evaluated prospectively. Each patient received a customized treatment plan based on a clinical examination and consultation. Treatment outcomes were evaluated from patient photographs with and skin analysis was performed with an A-One Smart automated skin analysis system.
RESULTS: The mean age of the patients was 41.7 years and the approximate mean duration of treatment was 160 days. Patients applied cosmeceuticals such as retinoic acid. Outpatient procedures included the delivery of botulinum toxin or dermal fillers, thread lifting, chemical peels, etc. Upon treatment completion, significant improvements were noted in multiple domains: Skin elasticity and hydration increased, areas of hyper-pigmentation were less extensive, and there were fewer visible wrinkles and pores.
CONCLUSION: Outcomes of the present article suggest how important is to customize facial anti-aging treatments. Nonsurgical treatments carried out progressively, involving the patient to perform at-home treatments in associations with outpatient procedures, let to achieve facial improvements in terms of increased skin elasticity and hydration, reduction of hyperpigmentation, wrinkles, and pores
Endoscopic Submucosal Dissection of Gastric Neoplastic Lesions. An Italian, Multicenter Study
Endoscopic submucosal dissection (ESD) allows removing neoplastic lesions on gastric
mucosa, including early gastric cancer (EGC) and dysplasia. Data on ESD from Western countries
are still scanty. We report results of ESD procedures performed in Italy. Data of consecutive patients
who underwent ESD for gastric neoplastic removal were analyzed. The en bloc resection rate and
the R0 resection rates for all neoplastic lesions were calculated, as well as the curative rate (i.e., no
need for surgical treatment) for EGC. The incidence of complications, the one‐month mortality, and
the recurrence rate at one‐year follow‐up were computed. A total of 296 patients with 299 gastric
lesions (80 EGC) were treated. The en bloc resection was successful for 292 (97.6%) and the R0 was
achieved in 266 (89%) out of all lesions. In the EGC group, the ESD was eventually curative in 72.5%
(58/80) following procedure. A complication occurred in 30 (10.1%) patients. Endoscopic treatment
was successful in all 3 perforations, whereas it failed in 2 out of 27 bleeding patients who were
treated with radiological embolization (1 case) or surgery (1 case). No procedure‐related deaths at
one‐month follow‐up were observed. Lesion recurrence occurred in 16 (6.2%) patients (6 EGC and
10 dysplasia). In conclusion, the rate of both en bloc and R0 gastric lesions removal was very high in
Italy. However, the curative rate for EGC needs to be improved. Complications were acceptably low
and amenable at endoscopy
Secondary metabolite profile in induced tetraploids of wild Solanum commersonii Dun.
The main aim of this work was to study the leaf secondary metabolite profiles of artificially induced tetraploids (2n1⁄44x1⁄448) of Solanum commersonii, a diploid (2n1⁄42x1⁄424) wild potato species. The tetraploid genotypes of S. commersonii were produced by oryzalin treatment. Both HPLC-UV and LC/ MS analyses revealed that there were no qualitative differences in the metabolite profiles between the diploid S. commersonii and its tetraploids. By contrast, the results showed that the phenylpropanoid content was generally significantly higher in the tetraploids than in the diploid S. commersonii. Concerning the glycoalkaloids (GAs), the results provided evidence that the content of minor GAs (solanidenediol triose, solanidadienol lycotetraose, and solanidenol lycotetraose) was higher in tetraploids than in the diploid progenitor, while the content of major GAs (dehydrodemissine and dehydrocommersonine) was significantly higher in diploid S. commersonii than in its tetraploid genotypes. The results are discussed from the practical perspective of potato biodiversity enhancement
An italian experience of a new personalized injective protocol (Botutouch) for botulinum toxin application in aesthetic medicine
Botulinum toxin typeA (BoNTA) is widely used in aesthetic medicine as primary treatment
to reduce facial wrinkles. Major unmet needs in the field of the injection techniques
include dilution factor, injected volume and site. Since 2013, an innovative
protocol has been developed in our clinic that works on a double dilution volume,
identifies the injection site according to the specific anatomical-functional characteristics
of each patient's musculature and applies a gentle massage to the injected area
to optimize the toxin spread in the muscle. We retrospectively retrieved medical
records of subjects that underwent aesthetic treatments in our outpatient Italian
clinics from 2013. In cobotulinum toxin A was used in double dilution (100 AU in
5 mL of physiologic solution) and followed by a gentle massage after the injection to
increase the distribution into the muscle. 197 subjects, most of them drug-naïve
(81.7%), underwent 869 BoNTA treatments. On average, higher total units and volumes
were applied in first visits or older subjects whereas the lower ones were preferred
in following visits or younger subjects. As perceived by the patients, the
effects of BoNTA lasted more than 6 months in about 38% of the cases. 95.9% of
subjects declared to be satisfied,whereas 5.2% of adverse events were observed
(4.8% hematoma, 0.2% ptosis, and 0.2% tenderness). To date, we offer a BoNTA
treatment with the aim to maximize the results and consequent patient's satisfaction,
with low incidence of complications
Dietary Phytoestrogen Intake and Cognitive Status in Southern Italian Older Adults
Background: Aging society faces significant health challenges, among which cognitive-related disorders are emerging. Diet quality has been recognized among the major contributors to the rising prevalence of cognitive disorders, with increasing evidence of the putative role of plant-based foods and their bioactive components, including polyphenols. Dietary polyphenols, including phytoestrogens, have been hypothesized to exert beneficial effects toward brain health through various molecular mechanisms. However, the evidence on the association between dietary phytoestrogen intake and cognitive function is limited. The aim of this study was to investigate the association between phytoestrogen intake and cognitive status in a cohort of older adults living in Sicily, Southern Italy. Methods: Dietary information from 883 individuals aged 50 years or older was collected through a validated food frequency questionnaire. Cognitive status was assessed through the Short Portable Mental Status Questionnaire. Results: The highest total isoflavone (including daidzein and genistein) intake was inversely associated with cognitive impairment compared to the lowest (odds ratio (OR) = 0.43, 95% confidence interval (CI): 0.20–0.92). Higher intake of total lignans and, consistently, all individual compounds (with the exception of secoisolariciresinol) were inversely associated with cognitive impairment only in the unadjusted model. Conclusions: A higher intake of phytoestrogens, especially isoflavones, was associated with a better cognitive status in a cohort of older Italian individuals living in Sicily. Taking into account the very low intake of isoflavones in Italian diets, it is noteworthy to further investigate selected populations with habitual consumption of such compounds to test whether these results may be generalized to the Italian population
Relationship between Pre-Implant Interleukin-6 Levels, Inflammatory Response, and Early Outcome in Patients Supported by Left Ventricular Assist Device: A Prospective Study
Purpose: The immune response is crucial in the development of multi-organ failure (MOF) and complications in end-stage heart failure patients supported by left ventricular assist device (LVAD). However, at pre-implant, the association between inflammatory state and post-LVAD outcome is not yet clarified. Aim of the study was to assess the relationship among preimplant levels of immune-related cytokines, postoperative inflammatory response and 3-month outcome in LVAD-patients. Methods: In 41 patients undergoing LVAD implantation, plasma levels of interleukin (IL)-6, IL-8, crucial for monocyte modulation, and urine neopterin/creatinine ratio (Neo/Cr), marker of monocyte activation, were assessed preoperatively, at 3 days, 1 and 4 weeks post-LVAD. MOF was evaluated by total sequential organ failure assessment (tSOFA) score. Intensive care unit (ICU)-death and/or post-LVAD tSOFA 11. Pre-implant level of IL-6 $ 8.3 pg/mL was identified as significant marker of discrimination between patients with or without adverse outcome (OR 6.642, 95% CI 1.201-36.509, p = 0.030). Patients were divided according to pre-implant IL-6 cutoff of 8.3 pg/ml in A [3.5 (1.2-6.1) pg/mL] and B [24.6 (16.4-38.0) pg/mL] groups. Among pre-implant variables, only white blood cells count was independently associated with pre-implant IL-6 levels higher than 8.3 pg/ml (OR 1.491, 95% CI 1.004-2.217, p = 0.048). The ICU-stay and hospitalisation resulted longer in B-group (p = 0.001 and p = 0.030, respectively). Postoperatively, 1 week-tSOFA score, IL-8 and Neo/Cr levels were higher in B-group. Conclusions: LVAD-candidates with elevated pre-implant levels of IL-6 are associated, after intervention, to higher release of monocyte activation related-markers, a clue for the development of MOF, longer clinical course and poor outcome
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