Adattamenti biochimici alla speleologia alpina

La speleologia è un esercizio fisico di tipo aerobico anaerobico alternato di lunghissima durata (10-30 ore) con carico motorio molto intenso e vario. Questa attività richiede un’elevata conoscenza degli schemi motori posturali e dinamici, adattabilità delle capacità senso-percettive all’ambiente, sviluppo delle capacità coordinative speciali e condizionali. Scopo della ricerca: indagare quali fossero gli eventuali adattamenti biochimici indotti da questa attività.Caving is a form of physical excise, alternating between aerobic and anaerobic, with a very long duration (10-30 hours) and an extremely intense and varied motor load. The activity requires an in-depth knowledge of postural and dynamic motor patterns, sensory-perceptual skills that can easily adapt to the environment and highly developed specialized and conditional coordination skills. Aim of the study: explore the possible biochemical adaptations induced by this activity

Prolonged exercise in type 1 diabetes: performance of a customizable algorithm to estimate the carbohydrate supplements to minimize glycemic imbalances

Physical activity in patients with type 1 diabetes (T1DM) is hindered because of the high risk of glycemic imbalances. A recently proposed algorithm (named Ecres) estimates well enough the supplemental carbohydrates for exercises lasting one hour, but its performance for prolonged exercise requires validation. Nine T1DM patients (5M/4F; 35-65 years; HbA1c 54 \ub1 13 mmol \ub7 mol(-1)) performed, under free-life conditions, a 3-h walk at 30% heart rate reserve while insulin concentrations, whole-body carbohydrate oxidation rates (determined by indirect calorimetry) and supplemental carbohydrates (93% sucrose), together with glycemia, were measured every 30 min. Data were subsequently compared with the corresponding values estimated by the algorithm. No significant difference was found between the estimated insulin concentrations and the laboratory-measured values (p = NS). Carbohydrates oxidation rate decreased significantly with time (from 0.84 \ub1 0.31 to 0.53 \ub1 0.24 g \ub7 min(-1), respectively; p < 0.001), being estimated well enough by the algorithm (p = NS). Estimated carbohydrates requirements were practically equal to the corresponding measured values (p = NS), the difference between the two quantities amounting to -1.0 \ub1 6.1 g, independent of the elapsed exercise time (time effect, p = NS). Results confirm that Ecres provides a satisfactory estimate of the carbohydrates required to avoid glycemic imbalances during moderate intensity aerobic physical activity, opening the prospect of an intriguing method that could liberate patients from the fear of exercise-induced hypoglycemia

Paratiroidectomia mini-invasiva video-assistita e monitoraggio intraoperatorio del paratormone

Background. Aim of this study is to analyze our preliminary results from minimally invasive video-assisted parathyroidectomy (MIVAP) and to evaluate the clinical impact of intraoperative measurements of intact parathyroid hormone (PTHIO). Patients and methods. MIVAP by an anterior approach was proposed for patients with sporadic primary hyperparathyroidism pHPT and one unequivocally enlarged parathyroid gland on preoperative ultrasound and 99mTc-SestaMIBI scintigraphy. We used an operative technique first described by Miccoli in 1997, without carbon dioxide insufflation. Quick parathyroid hormone immunochemiluminometric assay (qPTHa) was performed intraoperatively during all surgical procedures. Age, operative times, pathologic findings, postoperative pain, calcemia, length of hospital stay, cosmetic results, and complications were retrospectively analyzed. Results. From October 2006 to December 2009, MIVAP was proposed for 28 of 40 (70%). Mean operative time was 65 minutes. Postoperative complications included 4 (12.9%) transient hypocalcemia and one (3.22%) transient nerve palsy with complete recovery. No definitive laryngeal nerve palsies, no definitive hypocalcemias, no persistent pHPT and no recurrent pHPT were observed. The cosmetic result was excellent in all cases. Conclusions. Our preliminary results demonstrate that MIVAP for localized single-gland adenoma, after adequate training, seems to be feasible with significant advantages, especially in terms of cosmetic results, postoperative pain, and postoperative recovery, if performed by dedicated team, with a sufficient and specific activity volume

Association between thyroid hormones and TRAIL

11noRecent studies suggest that a circulating protein called TRAIL (TNF-related apoptosis-inducing ligand) might have a role in the regulation of body weight and metabolism. Interestingly, thyroid hormones seem to increase TRAIL tissue expression. This study aimed at evaluating whether overt thyroid disorders affected circulating TRAIL levels.openopenBernardi, Stella; Bossi, Fleur; Toffoli, Barbara; Giudici, Fabiola; Bramante, Alessandra; Furlanis, Giulia; Stenner, Elisabetta; Secchiero, Paola; Zauli, Giorgio; Carretta, Renzo; Fabris, BrunoBernardi, Stella; Bossi, Fleur; Toffoli, Barbara; Giudici, Fabiola; Bramante, Alessandra; Furlanis, Giulia; Stenner, Elisabetta; Secchiero, Paola; Zauli, Giorgio; Carretta, Renzo; Fabris, Brun

Interchangeability of procalcitonin measurements using the point of care testing i-CHROMA\u2122reader and the automated liaison XL

BACKGROUND: Our aim was to verify if procalcitonin (PCT) measurements using the new point-of-care testing i-CHROMATM are interchangeable with those of Liaison XL. METHODS: One hundred seventeen serum samples were processed sequentially on a Liaison XL and i-CHROMATM. Statistical analysis was done using the Passing-Bablok regression, Bland-Altman test, and Cohen's Kappa statistic. RESULTS: Proportional and constant differences were observed between i-CHROMATM and Liaison XL. The 95% CI of the mean bias% was very large, exceeding the maximum allowable TE% and the clinical reference change value. However, the concordance between methods at the clinical relevant cutoffs was strong, with the exception of the 0.25 ng/mL cutoff which was moderate. CONCLUSIONS: Our data suggest that i-CHROMATM is not interchangeable with Liaison XL. However, while the strong concordance at the clinical relevant cutoffs allows us to consider i-CHROMATM a suitable option to Liaison XL to support clinicians' decision-making; nevertheless, the moderate agreement at the 0.25 ng/mL cutoff recommends caution in interpreting the data around this cutoff

Relationship between insulin concentrations estimated by the <i>Ecres</i> algorithm and the corresponding laboratory-measured values.

<p>The relationship between estimated and measured insulin concentrations was statistically significant (R = 0.771, p < 0.001, n = 81). Dashed lines are the 95% Confidence Limits. Dashed-dotted line is the identity line.</p

Comparison between the estimated amounts of required carbohydrates and the corresponding actually administered quantities.

<p>Relationship between the amounts of required carbohydrates estimated by the algorithm for the 30 min exercise periods and the actually administered quantities. The relationship was statistically significant and close to the identity line (R = 0.788, p < 0.001, n = 54). Dashed lines are the 95% Confidence Limits. Dashed-dotted line is the identity line.</p

Comparison between the estimated carbohydrates oxidation rate and the corresponding actually measured values.

<p>Relationship between the estimated carbohydrates oxidation rates over 30 min period of the exercise and corrected for the overall exercise duration, and the actually measured values. The relationship was statistically significant and close to the identity line (R = 0.877, p < 0.001, n = 54). Dashed lines are the 95% Confidence Limits. Dashed-dotted line is the identity line.</p

Plasma insulin concentrations throughout the trials.

<p>Average laboratory measured plasma insulin concentrations (full dots and thick line) at rest, before and throughout the 3-h exercise is plotted against day-time; thin lines are the individual concentrations.</p

Blood glucose levels throughout the trials.

<p>Average glycemia (dots and thick line) throughout the trials is plotted against day-time; thin lines are the individual blood glucose levels at rest, before and throughout the 3-h exercise are also illustrated. Horizontal dashed lines: hypoglycemic and hyperglycemic thresholds.</p