Role of Fibre in Nutritional Management of Pancreatic Diseases

The role of fibre intake in the management of patients with pancreatic disease is still controversial. In acute pancreatitis, a prebiotic enriched diet is associated with low rates of pancreatic necrosis infection, hospital stay, systemic inflammatory response syndrome and multiorgan failure. This protective effect seems to be connected with the ability of fibre to stabilise the disturbed intestinal barrier homeostasis and to reduce the infection rate. On the other hand, in patients with exocrine pancreatic insufficiency, a high content fibre diet is associated with an increased wet fecal weight and fecal fat excretion because of the fibre inhibition of pancreatic enzymes. The mechanism by which dietary fibre reduces the pancreatic enzyme activity is still not clear. It seems likely that pancreatic enzymes are absorbed on the fibre surface or entrapped in pectin, a gel-like substance, and are likely inactivated by anti-nutrient compounds present in some foods. The aim of the present review is to highlight the current knowledge on the role of fibre in the nutritional management of patients with pancreatic disorders

Chapter Il rilievo di strada tra conoscenza e valorizzazione urbana: via dei Papareschi a Roma

The 43rd UID conference, held in Genova, takes up the theme of ‘Dialogues’ as practice and debate on many fundamental topics in our social life, especially in these complex and not yet resolved times. The city of Genova offers the opportunity to ponder on the value of comparison and on the possibilities for the community, naturally focused on the aspects that concern us, as professors, researchers, disseminators of knowledge, or on all the possibile meanings of the discipline of representation and its dialogue with ‘others’, which we have broadly catalogued in three macro areas: History, Semiotics, Science / Technology. Therefore, “dialogue” as a profitable exchange based on a common language, without which it is impossible to comprehend and understand one another; and the graphic sign that connotes the conference is the precise transcription of this concept: the title ‘translated’ into signs, derived from the visual alphabet designed for the visual identity of the UID since 2017. There are many topics which refer to three macro sessions: - Witnessing (signs and history) - Communicating (signs and semiotics) - Experimenting (signs and sciences) Thanks to the different points of view, an exceptional resource of our disciplinary area, we want to try to outline the prevailing theoretical-operational synergies, the collaborative lines of an instrumental nature, the recent updates of the repertoires of images that attest and nourish the relations among representation, history, semiotics, sciences

Role of continuous glucose monitoring in diabetic patients at high cardiovascular risk. an expert-based multidisciplinary delphi consensus

Background: Continuous glucose monitoring (CGM) shows in more detail the glycaemic pattern of diabetic subjects and provides several new parameters (“glucometrics”) to assess patients’ glycaemia and consensually guide treatment. A better control of glucose levels might result in improvement of clinical outcome and reduce disease complications. This study aimed to gather an expert consensus on the clinical and prognostic use of CGM in diabetic patients at high cardiovascular risk or with heart disease. Methods: A list of 22 statements concerning type of patients who can benefit from CGM, prognostic impact of CGM in diabetic patients with heart disease, CGM use during acute cardiovascular events and educational issues of CGM were developed. Using a two-round Delphi methodology, the survey was distributed online to 42 Italian experts (21 diabetologists and 21 cardiologists) who rated their level of agreement with each statement on a 5-point Likert scale. Consensus was predefined as more than 66% of the panel agreeing/disagreeing with any given statement. Results: Forty experts (95%) answered the survey. Every statement achieved a positive consensus. In particular, the panel expressed the feeling that CGM can be prognostically relevant for every diabetic patient (70%) and that is clinically useful also in the management of those with type 2 diabetes not treated with insulin (87.5%). The assessment of time in range (TIR), glycaemic variability (GV) and hypoglycaemic/hyperglycaemic episodes were considered relevant in the management of diabetic patients with heart disease (92.5% for TIR, 95% for GV, 97.5% for time spent in hypoglycaemia) and can improve the prognosis of those with ischaemic heart disease (100% for hypoglycaemia, 90% for hyperglycaemia) or with heart failure (87.5% for hypoglycaemia, 85% for TIR, 87.5% for GV). The experts retained that CGM can be used and can impact the short- and long-term prognosis during an acute cardiovascular event. Lastly, CGM has a recognized educational role for diabetic subjects. Conclusions: According to this Delphi consensus, the clinical and prognostic use of CGM in diabetic patients at high cardiovascular risk is promising and deserves dedicated studies to confirm the experts’ feeling

SURVEYING TO UNDERSTANDING AND VALORIZING THE URBAN IMAGE: THE ISOLA SACRA AREA IN FIUMICINO. EL LEVANTAMIENTO PARA EL CONOCIMIENTO Y LA MEJORA DE LA IMAGEN URBANA: LA ZONA DE ISOLA SACRA EN FIUMICINO

La intención del estudio es convertir en científico un proceso de conocimiento, de análisis e interpretación crítica de la complejidad urbana condicionada no solo por factores arquitectónicos sino también, por aspectos culturales, políticos y económicos. El objetivo consiste en partir de la comprensión de un lugar, para llegar a la elaboración de proyectos que sean capaces de reinterpretar la historia y a estimular y respaldar un debate siempre abierto en la perspectiva cada vez más amplia de la gestión del patrimonio cultural italiano. El área de estudio elegida es Isola Sacra, en el municipio de Fiumicino, encerrada entre Ostia Antica y el puerto de Trajano, inmersa dentro del parque natural de la costa romana. Es una isla auténtica, situada en la desembocadura del río Tíber, formada artificialmente por el alargamiento del canal que se excavó en la época de la antigua Ropa para conectar el río con el puerto imperial. Desde los años setenta, de manera intermitente, la zona ha sufrido muchos cambios en la construcción, debido principalmente al desarrollo del aeropuerto de Fiumicino. A partir de los numerosos estudios realizados a nivel nacional en este territorio articulado y complejo, uno de los objetivos es recavar la documentación existente para tratar de implementar un sistema que ya se ha estudiado y organizado con el fin de hacer frente con conocimiento a la gestión y/o a la futura distribución/expansión del área. La intención es aquella de estructurar y convertir en estándar un procedimiento basado en metodologías integradas para llegar a conocer este territorio; todos los análisis directos e indirectos, las comparaciones entre documentos históricos y actuales, las operaciones de descubrimiento a diferentes escalas, la investigación fotográfica del lugar y la elaboración de datos de levantamiento contribuirán a definir y realizar representaciones significativas del contexto urbano y de los episodios seleccionados como muestra para sugerir la valorización y la recalificación.The study aims to provide a scientific basis for the process of understanding, analyzing and critical interpretation of urban complexity, which is affected not only by architectural factors but also by cultural, political and economic aspects. The objective is to start from the knowledge thus gained about a place, which can then lead to projects capable of reinterpreting history as well as stimulating and sustaining the ongoing debate in the broader panorama of managing Italy’s cultural heritage. The area selected for investigation is Isola Sacra, a portion of the municipality of Fiumicino between Ostia Antica and Portus, now part of the Roman coastline nature reserve. It is an artificial island, created at the mouth of the Tiber during Trajan’s reign, when a navigable canal was extended to link the river to the Imperial port. During the 1970s, the town saw many construction projects in alternating stages, largely in connection with the development of Fiumicino airport. Starting from the numerous studies conducted of this complex and many-faceted area in Italy, one of this paper’s goals is to carry out a systematic review of the existing documentation, determining what has already been studied and organizing what can still be done in order to develop a well-informed approach to managing the area or doing further work on it. The intention is to establish a standard procedure based on integrated methods that will enable us to gain a better understanding of this area: all of the direct and indirect analyses, comparisons between historical and current documentation, surveying operations at various scales, the photographic investigation of the area and processing of survey data will all contribute to producing significant representations of the urban setting and of the individual episodes that were sampled in order to suggest approaches to valorizing and renewing the area

Conservazione, fruizione sostenibile e adeguamento funzionale: il pre-progetto

L'articolo illustra iil pre-progetto elaborato nel quadro della Ricerca finalizzata alla definizione di un modello di conservazione e di fruizione sostenibile per il Teatro Greco-Romano di Taormina Sono in particolare elencati i vincoli pre-progettuali, le considerazioni funzionali e i criteri progettuali adottati per assicurare la razionalizzazione delle attività che si svolgono nel sito del Teatro come pure la loro sostenibilità a medio-lungo termine.The article iil pre-project developed under the Research aimed at defining a model for the conservation and sustainable use for the Greek-Roman Theatre of TaorminaSono in particular the constraints listed pre-planning, functional considerations and design criteria adopted for ensure the rationalization of the activities that take place at the site of the theater as well as their sustainability in the medium to long term

Progetto finalizzato alla definizione di un modello di conservazione e di fruizione sostenibile per il Teatro Greco-Romano di Taormina

Il Progetto Pilota del Teatro Antico di Taormina comprende tra i suoi obiettivi principali, la costruzione di un percorso delle varie tappe della conoscenza, che siano utili ad interpretare la realtà dell’edificio e del suo contesto ambientale, e che, avendone verificatane l’efficacia, possa codificarsi come prassi da attuare sulle altre architetture teatrali antiche siciliane. L’individuazione di tale prassi, articolata in tre fasi (conoscitiva, interpretativa, operativa), permette di raggiungere pienamente uno dei risultati attesi prioritari del modello di progetti pilota adottato, definendo criteri, scansione temporale delle attività, metodiche e competenze. La presente ricerca si pone dunque un duplice obiettivo: da un lato concorrere operativamente alla realizzazione di alcune delle attività definite dal Progetto Pilota, dall’altro proporre un percorso metodologico ed operativo che consenta di passare, anche attraverso una fase di studio metaprogettuale, dai criteri e dalle prescrizioni di carattere generale a precise indicazioni di intervento in grado di rispondere alla acclarata necessità di “usare conservando”: la ricerca parte infatti dall’assunto che è opportuno utilizzare il teatro greco romano di Taormina per spettacoli e manifestazioni, ma che è altrettanto necessario individuare tipi e modi di realizzazione delle attività teatrali e musicali che siano in linea con chiari criteri e parametri di sostenibilità delle diverse componenti che rendono viva la macchina teatrale

Exercise-Induced Gastrointestinal Symptoms in Endurance Sports: A Review of Pathophysiology, Symptoms, and Nutritional Management

Strenuous exercise can be associated with “Exercise Induced Gastrointestinal Syndrome” (Ex-GIS), a clinical condition characterized by a series of gastrointestinal (GI) disturbances that may impact the physical and psychological performance of athletes. The pathophysiology comprises multi-factorial interactions between the GI tract and the circulatory, immune, enteric, and central nervous systems. There is considerable evidence for increases in the indices of intestinal damage, permeability, and endotoxemia associated with impaired gastric emptying, slowing of small intestinal transit, and malabsorption of nutrients. Heat stress and racing mode seem to exacerbate these GI disturbances. GI symptomatology that derives from strenuous exercise is similar to that of IBS and other GI functional disorders defined in the Rome IV Criteria. To manage Ex-GIS, the exercise modality, state of dehydration, environmental temperature, concomitant therapies, and self-managed diet should be evaluated, and if risk elements are present, an attempt should be made to modify them. Multiple strategies can be successively adopted to manage Ex-GIS. Nutritional and behavioral interventions appear to be the principal ones to avoid symptoms during the exercise. The aim of this review will be to explore the pathophysiology, clinical aspect, and current literature on behavioral and nutritional strategies to manage Ex-GIS, regarding a gluten-free diet and low-fermentable oligo-, di-, and mono-saccharides and polyols (FODMAP) diet