Mangosteen Extract Shows a Potent Insulin Sensitizing Effect in Obese Female Patients: A Prospective Randomized Controlled Pilot Study.

There is a widely acknowledged association between insulin resistance and obesity/type 2 diabetes (T2DM), and insulin sensitizing treatments have proved effective in preventing diabetes and inducing weight loss. Obesity and T2DM are also associated with increased inflammation. Mangosteen is a tropical tree, whose fruits—known for their antioxidant properties—have been recently suggested having a possible further role in the treatment of obesity and T2DM. The objective of this pilot study has been to evaluate safety and efficacy of treatment with mangosteen extract on insulin resistance, weight management, and inflammatory status in obese female patients with insulin resistance. Twenty-two patients were randomized 1:1 to behavioral therapy alone or behavioral therapy and mangosteen and 20 completed the 26-week study. The mangosteen group reported a significant improvement in insulin sensitivity (homeostatic model assessment-insulin resistance, HOMA-IR −53.22% vs. −15.23%, p = 0.004), and no side effect attributable to treatment was reported. Given the positive preliminary results we report and the excellent safety profile, we suggest a possible supplementary role of mangosteen extracts in the treatment of obesity, insulin resistance, and inflammation

Effects of plasma transfusion on hepcidin production in human congenital hypotransferrinemia

Hepcidin is the key regulator of systemic iron homeostasis. We describe the modulation of hepcidin production induced by plasma transfusions in a patient with congenital hypotransferrinemia that offers a unique model in which to study the mechanism of hepcidin regulation by iron and erythropoiesis. Urinary hepcidin increased from zero at baseline, when hemoglobin and serum transferrin was low, to a maximum of 98 ng/mg creatinine on day 60, and subsequently decreased. Time-course of urinary hepcidin and serum transferrin concentration suggests that hepcidin production is regulated by the combination of marrow iron requirements and iron supply by transferrin

Rhabdomyolysis after Intravenous Ferric Gluconate: A Case Report

Patients with severe iron deficiency, malabsorption or intolerance to oral iron are frequently treated with intravenous iron replacement. We report the case of a 42-year-old woman with non-erosive oligoarticular arthritis with antiparietal cell antibodies and iron deficiency anemia secondary to menorrhagia and unresponsive to oral iron preparations. She was treated with an intravenous infusion of ferric gluconate. After the first infusion of 125 mg (in 250 mL saline), she developed transient pain in her knee and wrist joints. When the dose was subsequently halved, the patient showed no adverse symptoms in the next four infusions and had normalized hemoglobin levels and iron indices. However, after a subsequent 125 mg ferric gluconate infusion she developed severe leg pain, muscular and joint stiffness, and functional impairment of her hands, right foot, and ankle. Laboratory tests showed a progressive increase in creatine kinase, transaminase, and C-reactive protein that normalized several days after the infusion. Although rhabdomyolysis is not reported among endovenous iron-induced adverse events, our findings suggest that intravenous iron infusions might have increased free iron generation promoting oxidative joint and muscular injury, which would explain the joint pain and stiffness, and rhabdomyolysis. Greater attention should be paid to the more frequent cases of myalgia occurring after iron infusion, which may underlie a rhabdomyolytic event requiring clinical observation

Application of Multivariate Analysis, Support Vector Machines and Artificial Neural Network to the Processing of Nuclear Magnetic Resonance data of olive oil and fish oil samples for classification of geographic origin and discrimination between wild and farm fish.

Motivations Traceability and control of origin of food products are very important for the Consumers and for the European enforcement laboratories. For instance, The high added value of olive oil makes its control an important goal for EU producers and consumers. There is thus a need in developing analytical methods to ensure compliance with labeling, i.e.the control of geographical origin giving also support to the denominated protected origin (DPO) policy, and the determination of the genuineness of the product by the detection of eventual adulterations. Futhermore , EU regulations requires that origin, wild or farmed as well as geographic origin, of fish sold on the retail market be available to the consumers. Modern analytical techniques such as Nuclear Magnetic Resonance (NMR) provide very informative data on the composition in fatty acids and in other constituents of vegetable oils and fish oils. The combination of 1H NMR fingerprinting with multivariate analysis provides an original approach to study the profile of these oils in relation with geographical origin of olive oil or for discrimination between wild or farm origin for fish like salmons. Methods Concerning the experiment on fish oil, we used Support vector machines (SVMs) as a novel learning machine in the authentication of the origin of salmon. SVMs have the advantage of relying on a well-developed theory and have already proved to be successful in a number of practical applications. The method requires a very simple sample preparation of the fish oils extracted from the white muscle of salmon samples. Multivariate (chemometric) techniques are able to filter out the most relevant information from a spectrum, e.g. for a classification. In the experiment on olive oil samples, the principal component analysis (PCA) was carried out on the ~12,000 variables (chemical shifts) and four data sets were defined prior to PCA. Linear discriminant analysis (LDA) of the first 50 PC\u2019s was applied for classification of olive oil samples according to the geographic origin and year of production. The data analysis has been carried out with and without outliers, as well. Variable selection for LDA was achieved using: (i) the best five variables and (ii) an interactive forward stepwise manner. Results The use of SVMs for the discrimination between wild and farm salmon provides a new and effective method that eliminates the possibility of fraud through misrepresentation of the country of origin of salmon. The SVM has been able to distinguish correctly between the wild and farmed salmon; however ca. 5% of the country of origins were misclassified. Using LDA on the external validation sets the correct classification of olive oil varied between 47 and 75% (random selection), and between 35 and 92% (Kennard\u2013Stone selection (KS)) depending on geographic origin (country) and production years. A similar success rate could be achieved using partial least squares discriminant analysis (PLS DA). The success rate can be considerably improved by using probabilistic neural networks (PNN). Correct classification by PNN varied between 58 and 100% on the external validation sets. Other chemometric techniques, such as multiple linear regression, or generalized pair-wise correlation, did not give better results. Acknowledgements The authors are grateful to the Europeanproject COFAWS (European Commission DG RTD FP5 project GRD2\u20132000\u201331813) and to all the collaborators from the partners of this project (Eurofins Scientific (Nantes- France), North Atlantic Fisheries College (Scalloway, Shetland Islands - United Kingdom), SINTEF Fisheries and Aquaculture (Trondheim-Norway), Joint Research Centre (Ispra-Italy)) who contributed to the collection and preparation of fish samples, and for the authorization to exploit their NMR data in this work

Osservatorio Territoriale droga e tossicodipendenze. Il fenomeno delle dipendenze sul territorio della ASL MI 2. Anno 2007 - VIII Rapporto

Report on the state of legal and illegal substances use in the territory of the Local Healthcare Service-Mi 2, Province of Milan.L\u27analisi del fenomeno delle dipendenze nel territorio della Azienda Sanitaria Locale Provincia di Milano Due rappresenta l\u27ottavo rapporto pubblicato dall\u27OTDT del Dipartimento delle Dipendenze. Come avviene da anni, le analisi e gli approfondimenti contenuti contribuiranno in modo importante a rendere questo strumento utile alla programmazione territoriale di settore e al sistema di controllo di gestione aziendale. La maggior parte delle analisi epidemiologiche e tutti gli aspetti non convenzionali ed innovativi sono stati possibili grazie alla collaborazione con il CNR di Pisa, che ringrazio per l\u27impegno personale dei suoi esperti anche al di l? dei compiti definiti. Devo segnalare con piacere l\u27ampia partecipazione di operatori delle varie Unit? Operative del Dipartimento alla riflessione e poi alla stesura del rapporto. Non voglio entrare nel merito della illustrazione dei capitoli del rapporto e mi limito ad alcune considerazioni. Il rapporto, basato sui dati 2006 con alcune importanti escursioni nel 2007, appare veramente completo. Nell\u27invitare il lettore al diretto approfondimento dei suoi contenuti, mi limito a sottolineare alcuni elementi rappresentativi dell\u27evolvere del fenomeno sul territorio. Aumentano ancora i soggetti in cura alle UO SerT per uso di cocaina: tra i nuovi utenti, questi superano oramai il 50% e sopravanzano i nuovi utenti da eroina del 20% circa. L\u27impatto dei servizi alcologici sul territorio ? sempre pi? evidente, con un progressivo incremento dell\u27utenza in carico. Queste informazioni vanno per? lette alla luce delle stime di prevalenza, condotte anche quest\u27anno, che confermano una forte presenza di consumatori problematici di alcol, eroina e cocaina sul territorio della ASL MI2 e alla luce delle indagini di popolazione condotte dal CNR, qui pubblicate in forma di confronto tra la nostra zona e le tendenze regionali e nazionali. Anche queste indagini, ricche di informazioni e suggestioni, confermano che tra la popolazione generale e giovanile i consumi di sostanze sia legali che illegali sono diffusi e preoccupanti e meritano l\u27attenzione dei programmatori di politiche sanitarie e di educazione alla salute. Il lettore potr? farsi una idea della complessit? dei fenomeni di consumo, abuso e dipendenza, e delle loro relazioni intrinseche ed esterne. L\u27analisi ? organizzata dalla valutazione delle tendenze dei fenomeni sul territorio fino agli interventi di prevenzione cura e riabilitazione. Questo continuum rappresenta la chiave per affrontare con una visione realistica il "che fare". Il rapporto illustra chiaramente quanto "si faccia" nel territorio della ASL MI2 e richiama tutti i soggetti istituzionali a concorrere alla tutela dei cittadini con problemi di abuso e dipendenza da sostanze o comportamenti additivi. L\u27Osservatorio ha raggiunto un elevato standard di servizio utile per rappresentare la base per la redazione del Piano annuale di programmazione del Dipartimento recepito ampiamente nel fondamentale atto di programmazione e coordinamento dei servizi sanitari e socio sanitari curato dalla Azienda Sanitaria Locale. L\u27ampio spazio dedicato alle "regole" regionali e alla riorganizzazione della direzione sociale della ASL giunge in un momento delicato. Mentre scrivo inizia la fase applicativa della delibera di giunta regionale n. 5509 del 10 ottobre 2007 che accelera l\u27applicazione di alcuni principi cardine della filosofia regionale per il settore e i servizi accreditati. Ebbene ai professionisti dei servizi spetta attestare, con l\u27impegno e la competenza, il sostegno alle pi? moderne prassi di lettura dei fenomeni, il supporto operativo ad avanzate procedure istituzionali e l\u27intervento preventivo e clinico. Dott. Prof. Alfio Lucchini Direttore del Dipartimento tecnico funzionale delle Dipendenz

Osservatorio territoriale droga e tossicodipendenze. Il fenomeno delle dipendenze sul territorio della ASL MI 2. Anno 2008- IX Rapporto

Report on the state of legal and illegal substances use in the territory of the Local Healthcare Service-Mi 2, Province of MilanIl report analizza il fenomeno delle dipendenze nel territorio della ASL Milano 2. La descrizione del fenomeno si sviluppa intorno all\u27analisi degli indicatori individuati dall\u27Osservatorio Europeo delle Dipendenze di Lisbona (OEDT): 1-uso di sostanze nella popolazione generale (questo indicatore va a rilevare i comportamenti nei confronti di alcol e sostanze psicoattive da parte della popolazione generale); 2-prevalenza d\u27uso problematico delle sostanze psicoattive; 3-domanda di trattamento degli utilizzatori di sostanze; 4-mortalit? degli utilizzatori di sostanze; 5-malattie infettive. Altri due importanti indicatori che si stanno sviluppando, e che vengono qui illustrati, sono l\u27analisi delle Schede di Dimissione Ospedaliera (SDO) e gli indicatori relativi alle conseguenza sociali dell\u27uso di droghe (criminalit? droga correlata). Inoltre sono state applicate diverse metodologie standard di stima sia per quantificare la quota parte sconosciuta di utilizzatori di sostanze che non afferiscono ai servizi, sia per identificarne alcune caratteristiche

"Osservatorio territoriale droga e tossicodipendenze. Il fenomeno delle dipendenze nel territorio della ASL MI 2. Anno 2009- X Rapporto"

Report on the state of legal and illegal substances use in the territory of the Local Healthcare Service-MI 2, Province of Milan.Il Report analizza il fenomeno delle dipendenze nel territorio della ASL Milano 2. La descrizione del fenomeno si sviluppa intorno all\u27analisi degli indicatori individuati dall\u27Osservatorio Europeo delle Dipendenze di Lisbona (OEDT): 1-uso di sostanze nella popolazione generale (questo indicatore va a rilevare i comportamenti nei confronti di alcol e sostanze psicoattive da parte della popolazione generale); 2-prevalenza d\u27uso problematico delle sostanze psicoattive; 3-domanda di trattamento degli utilizzatori di sostanze; 4-mortalit? degli utilizzatori di sostanze; 5-malattie infettive. Altri due importanti indicatori che si stanno sviluppando, e che vengono qui illustrati, sono l\u27analisi delle Schede di Dimissione Ospedaliera (SDO) e gli indicatori relativi alle conseguenza sociali dell\u27uso di droghe (criminalit? droga correlata). Inoltre sono state applicate diverse metodologie standard di stima sia per quantificare la quota parte sconosciuta di utilizzatori di sostanze che non afferiscono ai servizi, sia per identificarne alcune caratteristiche

Ceftolozane/Tazobactam for Treatment of Severe ESBL-Producing Enterobacterales Infections: A Multicenter Nationwide Clinical Experience (CEFTABUSE II Study)

Background. Few data are reported in the literature about the outcome of patients with severe extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) infections treated with ceftolozane/tazobactam (C/T), in empiric or definitive therapy.Methods. A multicenter retrospective study was performed in Italy (June 2016-June 2019). Successful clinical outcome was defined as complete resolution of clinical signs/symptoms related to ESBL-E infection and lack of microbiological evidence of infection. The primary end point was to identify predictors of clinical failure of C/T therapy.Results. C/T treatment was documented in 153 patients: pneumonia was the most common diagnosis (n = 46, 30%), followed by 34 cases of complicated urinary tract infections (22.2%). Septic shock was observed in 42 (27.5%) patients. C/T was used as empiric therapy in 46 (30%) patients and as monotherapy in 127 (83%) patients. Favorable clinical outcome was observed in 128 (83.7%) patients; 25 patients were considered to have failed C/T therapy. Overall, 30-day mortality was reported for 15 (9.8%) patients. At multivariate analysis, Charlson comorbidity index >4 (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.9-3.5; P = .02), septic shock (OR, 6.2; 95% CI, 3.8-7.9; P < .001), and continuous renal replacement therapy (OR, 3.1; 95% CI, 1.9-5.3; P = .001) were independently associated with clinical failure, whereas empiric therapy displaying in vitro activity (OR, 0.12; 95% CI, 0.01-0.34; P < .001) and adequate source control of infection (OR, 0.42; 95% CI, 0.14-0.55; P < .001) were associated with clinical success.Conclusions. Data show that C/T could be a valid option in empiric and/or targeted therapy in patients with severe infections caused by ESBL-producing Enterobacterales. Clinicians should be aware of the risk of clinical failure with standard-dose C/T therapy in septic patients receiving CRRT

Hepcidin Expression in Iron Overload Diseases Is Variably Modulated by Circulating Factors

Hepcidin is a regulatory hormone that plays a major role in controlling body iron homeostasis. Circulating factors (holotransferrin, cytokines, erythroid regulators) might variably contribute to hepcidin modulation in different pathological conditions. There are few studies analysing the relationship between hepcidin transcript and related protein expression profiles in humans. Our aims were: a. to measure hepcidin expression at either hepatic, serum and urinary level in three paradigmatic iron overload conditions (hemochromatosis, thalassemia and dysmetabolic iron overload syndrome) and in controls; b. to measure mRNA hepcidin expression in two different hepatic cell lines (HepG2 and Huh-7) exposed to patients and controls sera to assess whether circulating factors could influence hepcidin transcription in different pathological conditions. Our findings suggest that hepcidin assays reflect hepatic hepcidin production, but also indicate that correlation is not ideal, likely due to methodological limits and to several post-trascriptional events. In vitro study showed that THAL sera down-regulated, HFE-HH and C-NAFLD sera up-regulated hepcidin synthesis. HAMP mRNA expression in Huh-7 cells exposed to sera form C-Donors, HFE-HH and THAL reproduced, at lower level, the results observed in HepG2, suggesting the important but not critical role of HFE in hepcidin regulation

Indici per la valutazione della qualit? ecologica dei laghi

Collection of methods to evaluate lake quality using biological element