45 research outputs found
Binge and Emotional Eating in obese subjects seeking weight loss treatment
Objective: Binge Eating Disorder (BED) is highly prevalent among individuals seeking weight loss treatment. Considering the possible trigger factors for BED, different studies focused on the role of emotional eating. The present study compared threshold, subthreshold BED, and subjects without BED in a population of overweight/obese individuals seeking weight loss treatment, considering the anamnesis, the eating disorder specific and general psychopathology, the organic and psychiatric comorbidity, the emotional eating as a trigger factor for binge eating, and the quality of life. Design: cross-sectional survey.Subjects: Four hundred thirty eight overweight subjects seeking weight loss treatment have been enrolled in the study. Measurements: Subjects have been evaluated by means of a clinical interview (SCID I) and different self-reported questionnaires (Eating Disorder Examination Questionnaire, Binge Eating Scale, Beck Depression Inventory, Spielberg's State-Trait Anxiety Inventory, Symptom Checklist 90, Emotional Eating Scale, and Obesity Related Well-Being questionnaire). Results: One hundred and five subjects (24% of the sample) fulfilled the DSM-IV criteria of lifetime BED, 146 (33.3%) fulfilled the criteria of lifetime subthreshold BED, and 187 (42.7%) subjects were diagnosed overweight non-BED. No correlations between the binges frequencies and the overweight levels were found. All the three groups showed high psychiatric comorbidities, and the three groups significantly differed in terms of emotional eating, which was positively correlated to the binge eating frequencies. Conclusions: Threshold and subthreshold BED deserve a careful psychopathological investigation and emotional eating seems to play a key role as trigger factor for binge eating. Obesity is associated with a high psychiatric comorbidity and a low quality of life, independently from the specific and general eating disorder psychopathology
[Towards a practical geology in Italy: sciences applied to territory in Italy between the ‘20s and the ‘30s of the 20th century]
Il prossimo 30 dicembre 2023 ricorrerà il centenario del Vincolo idrogeologico e forestale (R.D.L. 3267/1923). La norma è conosciuta anche come legge Serpieri, in memoria del suo illuminato ideatore e co-redattore assieme al giurista Romualdo Trifone (Roggero, 2022)...
[Article in Italian
Il lago ottocentesco di Villa Savoia (Roma)
Nel settore nordorientale dell'area urbana di Roma si trova il parco di Villa Ada, intensamente frequentato dalla cittadinanza per le sue bellezze naturalistiche ed architettoniche. La sovrapposizione di interventi antropici nel corso della storia antica e recente della Città Eterna ha determinato, in un peculiare contesto geologico e geomorfologico, una complessa evoluzione del territorio; allo stato attuale l'area verde richiede attenzione sia per la protezione e conservazione dei beni ambientali e culturali, sia per il monitoraggio dei fenomeni di dissesto e la tutela della pubblica incolumità. Il principale fattore di rischio è rappresentato infatti dalla elevata probabilità di formazione di sinkholes antropogenici, connessi allo sviluppo di cavità nel sottosuolo; rispetto a ciò vari Enti pubblici e privati hanno da tempo avviato ricerche, a partire dal censimento e mappatura della rete caveale ipogea e delle voragini conclamate o incipienti che sono largamente diffuse all'interno del comprensorio [...]
Clinical and psychological correlates of health-related quality of life in obese patients
<p>Abstract</p> <p>Background</p> <p>Health-related quality of life (HRQL) is poor in obese subjects and is a relevant outcome in intervention studies. We aimed to determine factors associated with poor HRQL in obese patients seeking weight loss in medical units, outside specific research projects.</p> <p>Methods</p> <p>HRQL, together with a number of demographic and clinical parameters, was studied with generic (SF-36, PGWB) and disease-specific (ORWELL-97) questionnaires in an unselected sample of 1,886 (1,494 women; 392 men) obese (BMI > 30 kg/m<sup>2</sup>) patients aged 20-65 years attending 25 medical units scattered throughout Italy. The clinics provide weight loss treatment using different programs. General psychopathology (SCL-90 questionnaire), the presence of binge eating (Binge Eating scale), previous weight cycling and somatic comorbidity (Charlson's index) were also determined. Scores on SF-36 and PGWB were compared with Italian population norms, and their association with putative determinants of HRQL after adjustment for confounders was assessed through logistic regression analysis.</p> <p>Results</p> <p>HRQL scores were significantly lower in women than in men. A greater impairment of quality of life was observed in relation to increasing BMI class, concurrent psychopathology, associated somatic diseases, binge eating, and weight cycling. In multivariate analysis, psychopathology (presence of previously-diagnosed mental disorders and/or elevated scores on SCL-90) was associated with lower HRQL scores on both psychosocial and somatic domains; somatic diseases and higher BMI, after adjustment for confounders, were associated with impairment of physical domains, while binge eating and weight cycling appeared to affect psychosocial domains only.</p> <p>Conclusions</p> <p>Psychopathological disturbances are the most relevant factors associated with poor HRQL in obese patients, affecting not only psychosocial, but also physical domains, largely independent of the severity of obesity. Psychological/psychiatric interventions are essential for a comprehensive treatment of obesity, and to improve treatment outcome and to reduce the burden of disease.</p
610 Fontan associated kidney and liver disease: can we predict organ involvement with echocardiographic assessment of systolic function and atrioventricular valve insufficiency?
Abstract
Aims
Fontan operation represents the surgical palliative option for congenital heart disease with single ventricle physiology. With the improvement of surgical and percutaneous technique, we are facing a growing population of patients with an unique pathophysiology and potential complications.
Methods and results
Patients that underwent Fontan palliation in our centre between 1993 and 2016 were included in this prospective study. We excluded patients with major congenital renal anomalies, those that underwent cardiac transplantation, and redo-Fontan patients. All the subjects underwent clinical evaluation, laboratory exams with complete renal and hepatic function, transient hepatic elastography, and complete cardiac evaluation. We used Schwartz equation for estimating glomerular filtration rate in patients younger than 18 years, and CDK-EPI equation for adult patients. We enrolled 35 patients, 46% female (N = 16), and 54% male (N = 19). Medium age was 17 years old, median age 15 years old (range: 10–31 years old). Medium time from Fontan completion was 160 months (range: 57–340 months). Regarding to cardiac anatomy, 10 patients had functional single left ventricle (FSLV, 28.5%) and 21 a functional single right ventricle (FSRV, 60%); 4 patients had undetermined single ventricle (11.5%). Total cavo-pulmonary connection (TCPC) with intracardiac lateral tunnel was performed in 7 patients (20%, N = 7), whereas 28 patients had TCPC with external conduit (80%). Data from echocardiographic evaluation showed a medium EF established with Simpson's method of 60% in patients with FSLV; patients with a FSRV or undetermined single ventricle had a medium FAC of 41.1%, with 15.1% having a reduced FAC < 35%. No FSLV patients had an EF < 50%. When using creatinine-based formula, data about renal function in our population showed a stage 2 chronic kidney disease (eGFR: 60–89 ml/min 1.73 mq) in 11% of total population (N = 4), that became 26% when using cystatin C-based equation (N = 9), with one patient showing a moderate reduced loss of kidney function (eGFR: 40–59 ml/min 1.73 mq). Urinalysis showed 29% (N = 10) of patients having microalbuminuria (microalbumin/creatinine ratio between 30 and 300 mg/g). Statistical analysis demonstrated a negative correlation between systolic function (TAPSE for FSRV) and cystatin C blood levels (Pearson's R −0.428, P = 0.053), and between systolic function (FAC and Simpson) and microalbuminuria (Pearson's R −0.414 with P = 0.049 and Pearson's R −0.754 with P = 0.019, respectively). Transient elastography reported 10 patients (29.4%) with abnormal hepatic stiffness for Fontan patients. That condition appeared to be more frequent in patients with higher grade of AV valve insufficiency (P < 0.05).
Conclusions
Our population showed an higher prevalence of FSRV Fontan patients, with an expected lower systolic function compared with FSLV. 2D evaluation of systolic function showed a linear inverse correlation with renal function, suggesting that Fontan patients need a closer renal monitoring. Hepatic stiffness, which is a warning sign of potential hepatic cirrhosis need to be monitored in all Fontan patients, especially those with a worse AV valve insufficiency
Sprofondamenti in aree urbane: il caso del parco “Ytzhak Rabin” (via Panama, Roma)
In Rome urban area, within the garden dedicated
to Ytzhak Rabin (a portion of the Villa Ada park),
occurrence of a few collapses has been observed for the first
time in September 2012. In the surroundings, presence of
underground cavities- mainly catacombs- is conversely well
documented by previous studies.
Local authorities were immediately informed of sinkholes
formation, because collapses occurred very close to a
playground located in a highly frequented sector of the garden.
Propagation processes of the phenomena, periodically
monitored since their first observation, significantly fastened
after a period of heavy rainfalls on Rome area in January-
February 2014. Thus, multidisciplinary geophysical
investigations have been started in agreement with Civil
Protection of Rome Municipality, who has taken preliminary
safety measures (installation of fences and danger signals).
Hitherto, 28 sinkholes have been identified, aligned along a
WNW-ESE trending zone, testifying localized collapses of the
roof of underground cavities, probably belonging to the
palaeocristian catacomb systems dug nearby Via Salaria.
Preliminary geophysical prospections have been performed in
a small test area, in order to verify methods applicability and
thus program a systematic survey of the whole garden.
Drillings, and direct exploration of the accessible galleries, will
complete the reconstruction of underground geometry and
conservation state of vaults and pillars. Once completed the
hazard assessment, the planning of urgent works is expected
in order to restore the complete use of the garden.Published25 - 422TR. Ricostruzione e modellazione della struttura crostaleN/A or not JC
Indagini geofisiche e geochimiche di un sinkhole in formazione nell’area di Guidonia (Lazio)
The Plio-Quaternary Acque Albule Basin is already
known for the occurrence of sinkholes; since the
spring 2014, it has been ongoing the study of an active subsidence
process, which formed a depressed area near the
Guidonia village. During the last year, the phenomenon has
become more intense giving rise to two collapses along the
eastern rim of the depression. Thus, geophysical and geogeochemical
investigation campaigns started in order to understand
the genesis and evolution of the phenomenon. Survey
results allowed a geological and structural characterization,
showing the presence of “travertino” at the depression margins
and its absence therein. It has been recognized, by the
geophysics, features with NW-SE and NNE-SSW direction
ascribable to a possible depression fracturing and consistent
with regional structural trends. Thus, it has been possible to
plan and perform geognostic investigation consisting in two
drillings aimed to define the stratigraphy of the marginal and
inner part of the depression.Published7 - 162TR. Ricostruzione e modellazione della struttura crostaleJCR Journa
The association of depression and all-cause and cause-specific mortality: an umbrella review of systematic reviews and meta-analyses
Background: Depression is a prevalent and disabling mental disorder that frequently co-occurs with a wide range of chronic conditions. Evidence has suggested that depression could be associated with excess all-cause mortality across different settings and populations, although the causality of these associations remains unclear. Methods: We conducted an umbrella review of systematic reviews and meta-analyses of observational studies. PubMed, PsycINFO, and Embase electronic databases were searched through January 20, 2018. Systematic reviews and meta-analyses that investigated associations of depression and all-cause and cause-specific mortality were selected for the review. The evidence was graded as convincing, highly suggestive, suggestive, or weak based on quantitative criteria that included an assessment of heterogeneity, 95% prediction intervals, small-study effects, and excess significance bias. Results: A total of 26 references providing 2 systematic reviews and data for 17 meta-analytic estimates met inclusion criteria (19 of them on all-cause mortality); data from 246 unique studies (N = 3,825,380) were synthesized. All 17 associations had P < 0.05 per random effects summary effects, but none of them met criteria for convincing evidence. Associations of depression and all-cause mortality in patients after acute myocardial infarction, in individuals with heart failure, in cancer patients as well as in samples from mixed settings met criteria for highly suggestive evidence. However, none of the associations remained supported by highly suggestive evidence in sensitivity analyses that considered studies employing structured diagnostic interviews. In addition, associations of depression and all-cause mortality in cancer and post-acute myocardial infarction samples were supported only by suggestive evidence when studies that tried to adjust for potential confounders were considered. Conclusions: Even though associations between depression and mortality have nominally significant results in all assessed settings and populations, the evidence becomes weaker when focusing on studies that used structured interviews and those that tried to adjust for potential confounders. A causal effect of depression on all-cause and cause-specific mortality remains unproven, and thus interventions targeting depression are not expected to result in lower mortality rates at least based on current evidence from observational studies