Sleep disturbances: one of the culprits of obesity-related cardiovascular risk?

Growing evidence suggested that Sleep Disorders (SD) could increase the risk of developing obesity and could contribute to worsen obesity-related cardiovascular risk. Further, obesity per se has been reported to blunt sleep homeostasis. This happens through several mechanisms. First of all, the excessive adipose tissue at neck and chest levels could represent a mechanical obstacle to breathe. Moreover, the visceral adipose tissue is known to release cytokines contributing to low-grade chronic inflammation that could impair the circadian rhythm. Also, nutrition plays an important role in sleep homeostasis. High fat and/or high carbohydrate diets are known to have a negative impact on both sleep quality and duration. In addition, obesity predisposes to a condition called "obstructive sleep apnea" that has a detrimental effect on sleep. SD could increase the risk and/or could contribute to worsen cardiovascular risk usually associated with obesity. The chronic low grade inflammation associated with obesity has been reported to increase the risk of developing hypertension, type 2 diabetes and dyslipidemia. In turn, improving quality of sleep has been reported to improve the management of these cardiovascular risk factors. Thus, the aim of this manuscript is to provide evidence on the association of obesity and SD and on how they could contribute to the risk of developing cardiovascular risk factors such as hypertension, dyslipidemia and type 2 diabetes in obesity

Adenoma of the Ceruminous Gland (Ceruminoma)

Tumor arising from the ceruminous glands of the external ear canal (EAC) are very rare and can present a diagnostic dilemma because of their varied clinical and histologic manifestations. To our knowledge, this is the first report to present a case of ceruminoma in pediatric age. We discuss the origin of these tumors and the importance of wide excision and of the immunohistochemistry for the diagnosis

Association between Mediterranean diet and hand grip strength in older adult women

BACKGROUND & AIMS: Mediterranean Diet (MD) is an eating pattern associated with multiple healthy benefits, including the conservation of skeletal muscle. Frailty is a major geriatric syndrome characterized by low muscle strength. The Hand Grip Strength (HGS) is the most frequently used indicator of muscle functional capacity for clinical purposes. The association between the adherence to the MD and HGS in elderly has not yet fully investigated. The goal of this study was to examine the association between the adherence to the MD and HGS in a not hospitalized elderly who participated in the project PERsonalised ict Supported Services for Independent Living and Active Ageing (PERSSILAA). METHODS: Eighty-four elderly women were consecutively enrolled (aged 60-85 years) in this cross-sectional observational study. Anthropometric measures were evaluated. A validated 14-item questionnaire PREDIMED (PREvención con DIeta MEDiterránea) was used for the assessment of adherence to the MD. Dietary data were collected by a 7-day food records. Muscle strength was measured by HGS using a grip strength dynamometer (KERN & SOHN GmbH). RESULTS: The majority of participants were overweight (46.4%). An average adherence to the MD was found in 52.4% of participants, while the minority of them showed a low adherence (21.4%). HGS > cut-point of 20 kg were found in 43 subjects (51.2%). According to the adherence to MD, 39% participants with HGS values higher than cut-point presented a high adherence score compared with 14% of those with lower values of HGS (p = 0.018). The participants with HGS > cut-point presented significantly higher PREDIMED score than those with HGS < cut-point (p < 0.001). Based on ROC curves, the most sensitive and specific cut-point for the PREDIMED score to predict HGS categories was ≥8. No evident correlations were observed between HGS and age, while HGS was negatively correlated with hip circumference (r = -0.233, p = 0.033) and BMI (r = -0.219, p = 0.045), and positively correlated with PREDIMED score (r = 0.598, p < 0.001). At binomial logistic regression analysis almost all 14-items of PREDIMED questionnaire were significantly associated with HGS adjusted for BMI. At multinomial logistic regression analysis to assess the association of the three classes of adherence to the MD with the HGS, after adjusting for BMI the lowest adherence to MD was associated with the lowest Odds Ratio of HGS (p < 0.001). CONCLUSIONS: This study evidenced a positive association between the adherence to the MD and muscle strength in a sample of active elderly women, stratified according to the HGS > cut-point of 20 kg. Our study highlights the usefulness of the developing health services to detect and prevent age-associated decline in physical performance in elderly subjects by addressing nutritional and physical intervention

Poly-L-lactic acid beta-tricalcium phosphate screws: a preliminary in vivo biocompatibility study.

The aim of this study is to assess the biocompatibility of two types of Poly-L-lactic acid (PLLA) screws (with either hydroxiapatite (HA) or β-tricalcium phosphate (β-TCP)) implanted in the left femur of four sheep euthanized at 42, 50, 57 and 84 days after surgery. Titanium screws were also implanted for comparison purposes. No signs of inflammation were seen in the 240 specimens. A rating of "+/-"for macrophages and "-"for neutrophils was assigned to all specimens. All specimens were assigned a rating which ranged from "+/-" to "+++" for fibroblasts and osteoblasts. The presence of macrophages, neutrophils and fibroblasts/osteoblasts was not statistically different for the four implantation periods. PLLA implants with β-TCP have a biocompatibility comparable to PLLA implants with HA

Lingual cyst with respiratory epithelium: the importance of differential diagnosis

Lingual cyst with respiratory epithelium (LCRE) is a very rare congenital cyst of the tongue, floor of the mouth, pharynx or hypopharynx with 21 cases reported in the literature (1, 2). Differential diagnosis is very important for patients presenting with lingual cysts, as this may impact treatment and follow-up. LCRE should be included in the different diagnosis of dermoid cyst (3), teratoid cyst (4), epidermoid cyst (5), thyroglossal duct cyst (6), lymphoepithelial cyst (7), mucocele or ranula (8). Each entity has a peculiar histologic presentation, although the clinical aspect may be very similar (1). The dermoid cyst is lined by a keratinized squamous epithelium and contains skin appendages in the cyst. Epidermoid cyst is similar to the dermoid cyst but is characterized by non-keratinized squamous epithelium and has a lumen filled of keratin. Teratoid cyst contains derivatives of the endoderm, ectoderm and/or mesoderm. The thyroglossal duct cyst is usually lined by columnar, stratified squamous epithelium, or an intermediate transition type of epithelium, with the mandatory presence of thyroid tissue in the cyst wall. Lymphoepithelial cyst is identified by the presence of the lymphoid aggregates in the cyst wall. A mucous retention cyst, so called mucocele or ranula, contains mucin and granulation tissue (1)

Does vitamin D play a role in autoimmune endocrine disorders? A proof of concept

In the last few years, more attention has been given to the "non-calcemic" effect of vitamin D. Several observational studies and meta-analyses demonstrated an association between circulating levels of vitamin D and outcome of many common diseases, including endocrine diseases, chronic diseases, cancer progression, and autoimmune diseases. In particular, cells of the immune system (B cells, T cells, and antigen presenting cells), due to the expression of 1α-hydroxylase (CYP27B1), are able to synthesize the active metabolite of vitamin D, which shows immunomodulatory properties. Moreover, the expression of the vitamin D receptor (VDR) in these cells suggests a local action of vitamin D in the immune response. These findings are supported by the correlation between the polymorphisms of the VDR or the CYP27B1 gene and the pathogenesis of several autoimmune diseases. Currently, the optimal plasma 25-hydroxyvitamin D concentration that is necessary to prevent or treat autoimmune diseases is still under debate. However, experimental studies in humans have suggested beneficial effects of vitamin D supplementation in reducing the severity of disease activity. In this review, we summarize the evidence regarding the role of vitamin D in the pathogenesis of autoimmune endocrine diseases, including type 1 diabetes mellitus, Addison's disease, Hashimoto's thyroiditis, Graves' disease and autoimmune polyendocrine syndromes. Furthermore, we discuss the supplementation with vitamin D to prevent or treat autoimmune diseases

Lingual cyst with respiratory epithelium: The importance of differential diagnosis

The lingual cyst with respiratory epithelium (LCRE) is a very rare congenital cyst of the tongue, floor of the mouth, pharynx, or hypopharynx with 21 cases reported in the literature [1,2]. Differential diagnosis is very important for patients presenting with lingual cysts, as this may impact treatment and follow-up. The LCRE should be included in the different diagnosis of a dermoid cyst [3], teratoid cyst [4], epidermoid cyst [5], thyroglossal duct cyst [6], lymphoepithelial cyst [7], and mucocele or ranula [8]. Each entity has a peculiar histologic presentation, although the clinical aspect may be very similar [1]. The dermoid cyst is lined by a keratinized squamous epithelium and contains skin appendages in the cyst. The epidermoid cyst is similar to the dermoid cyst but is characterized by non-keratinized squamous epithelium and has a lumen filled with keratin. The teratoid cyst contains derivatives of the endoderm, ectoderm, and/or mesoderm. The thyroglossal duct cyst is usually lined by columnar, stratified squamous epithelium, or an intermediate transition type of epithelium, with the mandatory presence of thyroid tissue in the cyst wall. The lymphoepithelial cyst is identified by the presence of lymphoid aggregates in the cyst wall. A mucous retention cyst, so-called mucocele or ranula, contains mucin and granulation tissue [1]. Read the full text [PDF

An approach to prevent frailty in community dwelling older adults: a pilot study performed in Campania region in the framework of the PERSSILAA project

We developed and tested an innovative physical training method in older adults that embeds the gym program into everyday life in the most conservative way possible. Physical training was included in the activities of local parishes where older women from Southern Italy spend most of their free time and was delivered by trained physical therapists with the support of an ICT tool known as CoCo. 113 older women (aged 72.0 [69.0-75.0] years) noncompliant to conventional exercise programs participated to the study. 57 of them underwent the final anthropometric assessment and 50 the final physical tests. In study completers handgrip strength and physical performance evaluated with the chair-stand, the two minutes step and the chair-sit and -reach tests significantly improved. Quality of life as evaluated with the EuroQol-5dimension (EQ-5D) questionnaire improved as well. In conclusion, a training program designed to minimally impact on life habits of older people is effective in improving fitness in patients noncompliant to other to physical exercise programs

Innovative approaches to active and healthy ageing: Campania experience to improve the adoption of innovative good practices

The demographic projections on the European population predict that people aged over 60 will increase by about two million/year in the next decades. Since 2012, the Campania Reference Site of the European Innovation Partnership on Active and Healthy Ageing supports the innovation of the Regional Health System, to face up demographic changes and sustainability. Campania Reference Site provides the opportunity to connect loco-regional stakeholders in social and health care services (universities, healthcare providers, social services, local communities and municipalities), with international organizations, in order to adopt and scale up innovative solutions and approaches. This paper describes the building process of Campania Reference Site and the main results achieved, that have been allowing it to become a hub for open innovation in the field of active and healthy aging at regional, national and international level