Seasonal pattern of vitamin D in male elite soccer players

The phopho-calcium metabolism and the maintenance of bone mass is not the only important role vitamin Dplays. Vitamin D is also known for its anti-inflammatory function and for modulating the immune defence system. The vitamin D deficit is to be referred not simply to a bone tissue worsening, but to cardiovascular diseases, various types of tumours and some autoimmune diseases. In the sport life, a vitamin D deficit is often related to muscular problems, neuromuscular pains, predisposition to injuries, and can affect one’s performance. Since indoor athletes have reduced exposition to sun rays, they are more likely to be subjected to these risks than outdoor athletes. However, in soccer, the athletes can experience vitamin D deficit not just during the winter but in other periods too, most likely due to several reasons such as, dark complexion, coming from high altitude championships, injuries, or inadequate exposition to sun rays during the summer. The purpose of this study was to examine the vitamin D shortage and BMC variations in Italian Serie A elite male soccer player

Cardiac Magnetic Resonance to Predict Cardiac Mass Malignancy: The CMR Mass Score

Background: Multimodality imaging is currently suggested for the noninvasive diagnosis of cardiac masses. The identification of cardiac masses' malignant nature is essential to guide proper treatment. We aimed to develop a cardiac magnetic resonance (CMR)-derived model including mass localization, morphology, and tissue characterization to predict malignancy (with histology as gold standard), to compare its accuracy versus the diagnostic echocardiographic mass score, and to evaluate its prognostic ability. Methods: Observational cohort study of 167 consecutive patients undergoing comprehensive echocardiogram and CMR within 1-month time interval for suspected cardiac mass. A definitive diagnosis was achieved by histological examination or, in the case of cardiac thrombi, by histology or radiological resolution after adequate anticoagulation treatment. Logistic regression was performed to assess CMR-derived independent predictors of malignancy, which were included in a predictive model to derive the CMR mass score. Kaplan-Meier curves and Cox regression were used to investigate the prognostic ability of predictors. Results: In CMR, mass morphological features (non-left localization, sessile, polylobate, inhomogeneity, infiltration, and pericardial effusion) and mass tissue characterization features (first-pass perfusion and heterogeneity enhancement) were independent predictors of malignancy. The CMR mass score (range, 0-8 and cutoff, ≥5), including sessile appearance, polylobate shape, infiltration, pericardial effusion, first-pass contrast perfusion, and heterogeneity enhancement, showed excellent accuracy in predicting malignancy (areas under the curve, 0.976 [95% CI, 0.96-0.99]), significantly higher than diagnostic echocardiographic mass score (areas under the curve, 0.932; P=0.040). The agreement between the diagnostic echocardiographic mass and CMR mass scores was good (κ=0.66). A CMR mass score of ≥5 predicted a higher risk of all-cause death (P<0.001; hazard ratio, 5.70) at follow-up. Conclusions: A CMR-derived model, including mass morphology and tissue characterization, showed excellent accuracy, superior to echocardiography, in predicting cardiac masses malignancy, with prognostic implications

Managing a Mass CO Poisoning: Critical Issues and Solutions From the Field to the Hyperbaric Chamber

Carbon monoxide acute intoxication is a common cause of accidental poisoning in industrialized countries and sometimes it produces a real mass casualty incident. The incident described here occurred in a church in the province of Verona, when a group of people was exposed to carbon monoxide due to a heating system malfunction. Fifty-seven people went to the Emergency Department. The mean carboxyhemoglobin (COHb) level was 10.1\ub15.7% (range: 3-25%). The clinicians, after medical examination, decided to move 37 patients to hyperbaric chambers for hyperbaric oxygen (HBO) therapy. This is the first case report that highlights and analyses the logistic difficulties of managing a mass carbon monoxide poisoning in different health care settings, with a high influx of patients in an Emergency Department and a complex liaison between emergency services. This article shows how it is possible to manage a complex situation with good outcome. (Disaster Med Public Health Preparedness. 2016;page 1 of 5)

Cardiac Magnetic Resonance to Predict Cardiac Mass Malignancy: The CMR Mass Score

BACKGROUND: Multimodality imaging is currently suggested for the noninvasive diagnosis of cardiac masses. The identification of cardiac masses' malignant nature is essential to guide proper treatment. We aimed to develop a cardiac magnetic resonance (CMR)-derived model including mass localization, morphology, and tissue characterization to predict malignancy (with histology as gold standard), to compare its accuracy versus the diagnostic echocardiographic mass score, and to evaluate its prognostic ability. METHODS: Observational cohort study of 167 consecutive patients undergoing comprehensive echocardiogram and CMR within 1-month time interval for suspected cardiac mass. A definitive diagnosis was achieved by histological examination or, in the case of cardiac thrombi, by histology or radiological resolution after adequate anticoagulation treatment. Logistic regression was performed to assess CMR-derived independent predictors of malignancy, which were included in a predictive model to derive the CMR mass score. Kaplan-Meier curves and Cox regression were used to investigate the prognostic ability of predictors. RESULTS: In CMR, mass morphological features (non-left localization, sessile, polylobate, inhomogeneity, infiltration, and pericardial effusion) and mass tissue characterization features (first-pass perfusion and heterogeneity enhancement) were independent predictors of malignancy. The CMR mass score (range, 0-8 and cutoff, ≥5), including sessile appearance, polylobate shape, infiltration, pericardial effusion, first-pass contrast perfusion, and heterogeneity enhancement, showed excellent accuracy in predicting malignancy (areas under the curve, 0.976 [95% CI, 0.96-0.99]), significantly higher than diagnostic echocardiographic mass score (areas under the curve, 0.932; P=0.040). The agreement between the diagnostic echocardiographic mass and CMR mass scores was good (κ=0.66). A CMR mass score of ≥5 predicted a higher risk of all-cause death (P<0.001; hazard ratio, 5.70) at follow-up. CONCLUSIONS: A CMR-derived model, including mass morphology and tissue characterization, showed excellent accuracy, superior to echocardiography, in predicting cardiac masses malignancy, with prognostic implications

Oxidative system in aged skeletal muscle

Aging is an inevitable biological process that is characterized by a general decline in the physiological and biochemical functions of the major systems. In the case of the neuromuscular system, reductions in strength and mobility cause a deterioration in motor performance, impaired mobility and disability. At the cellular level, aging is caused by a progressive decline in mitochondrial function that results in the accumulation of reactive oxygen species (ROS). As the level of oxidative stress in skeletal muscle increases with age, the age-process is characterized by an imbalance between an increase in ROS production in the organism, and antioxidant defences as a whole. We have reviewed the literature on oxidative stress in aging human skeletal muscles, and to assesss the impact of differences in physiological factors (sex, fiber composition, muscle type and function

Multidisciplinary studies of ancient calcified tissues: renal stones from mummies

The renal stones found in the mummies of Pandolfo III Malatesta, Lord of Fano (1370–1427) and an anonymous nobleman from Popoli (XVIII century) were investigated using different techniques. Both specimens were examined with binocular stereomicroscopy (BSM) and scanning electron microscopy (SEM), also with energy dispersive X-ray analysis (EDX). Multiple tiny fragments from surface and inner portions were submitted to X-ray diffraction (XRD) analysis. Subsequently, the calculi were imaged with microcomputed tomography (micro CT).The stone from Pandolfo had a mulberry-like surface with honey brown colour and measured 12 mm in largest diameter. Along with the organic constituents (C, O, and N), the following chemical elements were detected: K, S, Si, Cl, Ca, P, Na, and Ba. The calculus was composed of ammonium acid urate (95%) and calcium oxalate dihydrate (weddellite) (5%). Internal structure consisted of aggregated large spheroidal crystals with different density values. In the case from Popoli, the ovoidal mass with small superficial spherical buds measured 22×16×15 mm. The cut surface showed a central nucleus of sharp-edged crystals and concentric laminations. Detected chemical elements were: C, O, N,Ca, P, K, S, Cl, and Na. The stone composition was calcium oxalate monohydrate (whewellite; 90%) and calcium phosphate (hydroxylapatite; 10%). Internal structure detail revealed concentric laminations and aggregates of similar density values. These observations enabled us to propose an ideal protocol for the examination of stones that can be found in mummies and in osteoarcheological material. After preliminary observation with BSM, the specimen should be imaged with microCT, in order to trace a detailed map of the external surface and the whole calculus and guide the following SEM-EDX measurements for elemental distribution analysis. Matching the results from these methods avoids destructive XRD analysis and may allow to obtain an affordable evaluation of chemical composition on the entire stone, following a conservative approach