Asma, malattie respiratorie e apporto nutrizionale di acidi grassi e olio d'oliva: studio caso controllo in una popolazione italiana

Background. Fat intake has been associated to respiratory diseases, with conflicting results. Objective. To assess the association between respiratory diseases and animal and vegetable fats, monounsaturated (MUFA), saturated (SFA) and polyunsaturated fatty acids (PUFA). Design Population-based multi-case control study (Genes Environment Interaction in Respiratory Diseases (GEIRD) study) conducted in seven Italian centers. Participants. Subjects aged 20\u201384 years from the general population. Measurements. Clinical status and nutrient intake information was collected for 962 subjects: 145 with Current Asthma (CA), 77 with Past Asthma (PA), 77 with CB, 301 with Allergic Rhinitis (AR), 164 with Non Allergic Rhinitis (NAR) and 344 Controls. Food intake was collected through the Food Frequency Questionnaire EPIC (European Investigation into Cancer and Nutrition). The associations between fats and respiratory diseases were estimated by means of multinomial or logistic models. The different fats and foods were analyzed both as continuous variables and as quartiles. Results. A negative association between the intake of vegetable fats, MUFA, oleic acid and the risk of CA was found (RRR=0.69; 95%CI: 0.49;0.97 for oleic acid). The same association for MUFA (p=0.028) and oleic acid (p=0.022) against CA was found when they were categorized in quartiles. Olive oil was associated to a reduction of the risk of CA (RRR=0.79; 95%CI: 0.65;0.98). An increased risk of AR was associated with moderate animal fat intake, and an increased risk of NAR was associated with SFA intake. Conclusions. Dietary fats affect the risk of respiratory diseases in adults. High dietary intake of oleic acid and of olive oil are associated to a lower asthma risk

Restriction of dietary protein decreases mTORC1 in tumors and somatic tissues of a tumor-bearing mouse xenograft model

Reduced dietary protein intake and intermittent fasting (IF) are both linked to healthy longevity in rodents, and are effective in inhibiting cancer growth. The molecular mechanisms underlying the beneficial effects of chronic protein restriction (PR) and IF are unclear, but may be mediated in part by a down-regulation of the IGF/mTOR pathway. In this study we compared the effects of PR and IF on tumor growth in a xenograft mouse model of breast cancer. We also investigated the effects of PR and IF on the mechanistic Target Of Rapamycin (mTOR) pathway, inhibition of which extends lifespan in model organisms including mice. The mTOR protein kinase is found in two distinct complexes, of which mTOR complex 1 (mTORC1) is responsive to acute treatment with amino acids in cell culture and in vivo. We found that both PR and IF inhibit tumor growth and mTORC1 phosphorylation in tumor xenografts. In somatic tissues, we found that PR, but not IF, selectively inhibits the activity of the amino acid sensitive mTORC1, while the activity of the second mTOR complex, mTORC2, was relatively unaffected by PR. In contrast, IF resulted in increased S6 phosphorylation in multiple metabolic tissues. Our work represents the first finding that PR may reduce mTORC1 activity in tumors and multiple somatic tissues, and suggest that PR may represent a highly translatable option for the treatment not only of cancer, but also other age-related diseases

Information and Training on the Use of Telemedicine in Pediatric Population: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP), and of the Syndicate of Family Pediatrician Doctors (SIMPeF)

Telemedicine has entered the daily lives of doctors, although the digital skills of healthcare professionals still remain a goal to be achieved. For the purpose of a large-scale development of telemedicine, it is necessary to create trust in the services it can offer and to favor their acceptance by healthcare professionals and patients. In this context, information for the patient regarding the use of telemedicine, the benefits that can be derived from it, and the training of healthcare professionals and patients for the use of new technologies are fundamental aspects. This consensus document is a commentary that has the aim of defining the information on and training aspects of telemedicine for pediatric patients and their caregivers, as well as pediatricians and other health professionals who deal with minors. For the present and the future of digital healthcare, there is a need for a growth in the skills of professionals and a lifelong learning approach throughout the professional life. Therefore, information and training actions are important to guarantee the necessary professionalism and knowledge of the tools, as well as a good understanding of the interactive context in which they are used. Furthermore, medical skills can also be integrated with the skills of various professionals (engineers, physicists, statisticians, and mathematicians) to birth a new category of health professionals responsible for building new semiotics, identifying criteria for predictive models to be integrated into clinical practice, standardizing clinical and research databases, and defining the boundaries of social networks and new communication technologies within health services

Use of Telemedicine Healthcare Systems in Pediatric Assistance at Territorial Level: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP) and of the Syndicate of Family Pediatrician Doctors (SIMPeF)

Technological innovation can contribute to a reorganization of healthcare, particularly by supporting the shift in the focus of care from the hospital to the territory, through innovative citizen-centered models, and facilitating access to services in the territory. Health and social care delivery modalities, enabled by telemedicine, are crucial in this regard. The objective of this Consensus document, written by the main Italian Scientific Societies involved in the use of telemedicine in pediatrics, is to define a standard for its use at the territorial level in various declinations in the pediatric field; this paper also identifies priority areas for its application and the types of services that most require intervention and investment. The changes that are underway in digital transformation in all sectors are unstoppable, and for the digital transformation to take place in a productive sense, the contribution of not only all health professionals, but also of patients, is necessary. From this perspective, authors from different backgrounds were involved in the drafting of this Consensus and, in the future, other figures, primarily patients, are expected to be involved. In fact, this belongs to the vision of connected care, in which the citizen/patient actively participates in the treatment path so that they are assisted in a personalized, predictive and preventive way. The future scenario must be able to provide for the involvement of patients from the initial stages of planning any treatment path, even in the pediatric age, and increasing, where possible, the proximity of the health service to the families

Use of Telemedicine Healthcare Systems in Pediatric Assistance at Territorial Level: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP) and of the Syndicate of Family Pediatrician Doctors (SIMPeF)

Technological innovation can contribute to a reorganization of healthcare, particularly by supporting the shift in the focus of care from the hospital to the territory, through innovative citizen-centered models, and facilitating access to services in the territory. Health and social care delivery modalities, enabled by telemedicine, are crucial in this regard. The objective of this Consensus document, written by the main Italian Scientific Societies involved in the use of telemedicine in pediatrics, is to define a standard for its use at the territorial level in various declinations in the pediatric field; this paper also identifies priority areas for its application and the types of services that most require intervention and investment. The changes that are underway in digital transformation in all sectors are unstoppable, and for the digital transformation to take place in a productive sense, the contribution of not only all health professionals, but also of patients, is necessary. From this perspective, authors from different backgrounds were involved in the drafting of this Consensus and, in the future, other figures, primarily patients, are expected to be involved. In fact, this belongs to the vision of connected care, in which the citizen/patient actively participates in the treatment path so that they are assisted in a personalized, predictive and preventive way. The future scenario must be able to provide for the involvement of patients from the initial stages of planning any treatment path, even in the pediatric age, and increasing, where possible, the proximity of the health service to the families

Use of Telemedicine Healthcare Systems in Children and Adolescents with Chronic Disease or in Transition Stages of Life: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP) and of the Syndicate of Family Pediatrician Doctors (SIMPeF)

: Telemedicine is considered an excellent tool to support the daily and traditional practice of the health profession, especially when referring to the care and management of chronic patients. In a panorama in which chronic pathologies with childhood onset are constantly increasing and the improvement of treatments has allowed survival for them into adulthood, telemedicine and remote assistance are today considered effective and convenient solutions both for the chronic patient, who thus receives personalized and timely assistance, and for the doctors, who reduce the need for direct intervention, hospitalizations and consequent management costs. This Consensus document, written by the main Italian Scientific Societies involved in the use of telemedicine in pediatrics, has the objectives to propose an organizational model based on the relationships between the actors who participate in the provision of a telemedicine service aimed at minors with chronic pathologies, identifying specific project links between the areas of telemedicine in the developmental age from the first 1000 days of life to the age adult. The future scenario will have to be able to integrate digital innovation in order to offer the best care to patients and citizens. It will have to be able to provide the involvement of patients from the very beginning of the design of any care pathway, increasing where possible the proximity of the health service to citizens

Rapport III. 10 Conception et construction d'ouvrages de protection des littoraux des Marches, Abruzzes, Molise (Adriatique Central)

Coastal defence project in the Marche, Abruzzo and Molise regions (Italy) : standard selection of structures and coastal works. The problem of coastal erosion in Italy (approx. 7500 km of coasts) has reached alarming proportions in the last fifteen years, so much that 60-70% of the beaches is estimated to be in accelerated erosion or in extremely precarious conditions. This evolution, due to the combined actions of physical and mainly anthropic factors, has bought about significant changes in the environmental resources, with negative effects on the economic activities that thrive on the exploitation of the "coast resource". As a result, a series of sporadic and uncoordinated coastal protection structures were installed, thus defining situations of disorder in neighbouring areas. On the basis of these negative experiences, the Authorities of the Marche and Abruzzo jointly performed a "General study of physical and anthropic factors" which influence coastal dynamics. The results of this study have brought to a "General Project of defence works which is in progress along 300 km of the coastline. The total estimated cost of the Project is 150 Millions US Dollars ; it has so far been financed for the first two years with 65 Millions US Dollars and it can bee considered the first example af a rational work programma on the italian coastal areas undertaken by the Government.En 1981-83 les Autorités des Marches-Abruzzes-Molise ont réalisé ensemble une "Etude générale des facteurs physiques et humains qui influencent l'hydrodynamique des littoraux" de leur compétence. Les résultats de cette étude ont permis de mettre au point un "Plan général d'interventions de protection", actuellement en cours d'exécution sur environ 300 km de côte (82% de côte basse : 18% de côte haute). Une grande partie des littoraux (35%) a été intéressée par le passé par des interventions consistant presqu'exclusivement en ouvrages parallèles, du type rasant la côte (protection des villes des routes, de la voie ferrée) et du type brise-lames au large (sauvegarde des lieux de baignade). Les deux typologies ont eu des effets positifs locaux, mais ont déplacé à contre-courant le phénomène d'érosion en un enchaînement de causes et d'effets. Les conclusions de l'étude propédeutique ont orienté le projet vers d'autres types d'ouvrages, tels que : – cloisons immergées en blocs naturels ou en sacs de polyamide en mesure de modifier le profil sans causer la fuite des sédiments vers les hauts-fonds ; – brise-lames immergés, en mesure d'amortir les vagues de plus grande hauteur sans modifier celles de moindre hauteur, afin de garantir le renouvellement des eaux et de limiter les phénomènes de pollution ; – remblayages artificiels avec ou sans ouvrages de contention, afin de limiter les volumes versés. C'est la typologie la plus utilisée, et elle est relativement nouvelle pour l'Italie. En beaucoup d'endroits on a dû limiter l'intervention à un type de défense "passive", c'est à dire en mesure de réduire le phénomène érosif ; le plus souvent il a été possible au contraire d'exécuter des interventions en mesure de reconstruire une plage, pour l'utiliser dans des buts touristico-balnéaire. Le "Plan" dont la réalisation totale nécessite 240 milliards de lires, a été financé pour les années 1983-84 pour 90 millions de lires et représente le premier exemple en Italie d'interventions rationnelles et programmées sur le territoire côtier.Pedone Francesco, Spelta Silvio. Rapport III. 10 Conception et construction d'ouvrages de protection des littoraux des Marches, Abruzzes, Molise (Adriatique Central). In: L'hydraulique et la maitrise du littoral. Problèmes côtiers posés par le mouvement des sédiments et la pollution. Dix-huitièmes journées de l'hydraulique. Marseille, 11-13 septembre 1984. Tome 3, 1984

Calorie restriction, endothelial function and blood pressure homeostasis

A number of experimental animal studies have demonstrated that a chronic reduction in calorie intake decreases BP levels and prevents the development of hypertension [6–11]. The mechanisms through which this effect is mediated are not precisely known, but may include reductions in inflammation and oxidative stress, enhanced insulin sensitivity, and modifications in neuroendocrine and sympathetic nervous system function [12]. Data from short-term randomized clinical trials and of volunteers practicing long-termcalorie restriction (CR)without malnutrition have confirmed that a chronic reduction in calorie intake significantly decreases blood pressure and other related cardiometabolic risk factors that have been implicated in the pathogenesis of endothelial dysfunction [13–16]

Body weight and mortality in COPD: focus on the obesity paradox

The positive association between overweight, obesity, and cardiovascular and all-cause mortality is well established, even though this relation is typically U shaped with an increased risk also in low-weight subjects. However, being overweight or obese has been associated with a better prognosis in subjects suffering from chronic diseases, id est the "obesity paradox". In both community-dwelling and hospitalized patients with COPD, several studies have reported a significant protective effect of obesity on all-cause mortality, indicating that also in obstructive pulmonary diseases, an obesity paradox may be present. Interestingly, the "paradox" is more evident for subjects with severe bronchial obstruction (i.e., a lower FEV1), while in mild-moderate conditions, the weight-related mortality shows a behavior similar to that observed in the general population. Several factors may confound the relation between COPD, obesity and mortality. The lower FEV1 found in obese people may be linked to a restrictive defect rather than to an obstructive one. Due to the modified chest wall mechanical properties-related to increased fat mass-obese COPD patients may present, respect to their lean counterpart, a lower lung hyperinflation which is associated with higher mortality. The traditional classification of COPD attributes to obese "blue bloaters" a low-grade emphysema in opposition to lean "pink puffers"; the fact that emphysema extent is related to mortality may bias the relationship between weight and survival. It is also to underline that the majority of the studies, consider BMI rather than body composition (a better predictor of mortality) when studying the intriguing relation between weight, COPD, and mortality. Reverse bias has also to be taken into account, hypothesizing that an unintentional weight loss may be the deleterious factor related to mortality, rather than considering obesity a protective one. Further prospective studies are needed to shed light on the complexity of this emerging issue