Healthy status and energy balance in pediatrics

During growth, the human body increases in size and changes proportion of various components due to hormones mediators. Nutritional status is the result of introduction, absorption and utilization of the nutrients and it has a new definition in the relationship between nutritional status and healthy status. In this view energy balance, body function and body composition are three entities correlated each other. This mini-review article examines issues and techniques specifically related to a pediatric population in the field of body composition and energy expenditure. It is broadly divided into two sections. The first section discusses body composition measurements underlying principles, advantages, disadvantages and consensus. The second section reviews energy expenditure and physical activity measurement techniques. In conclusion general clinical suggestions are offered regarding pediatric body composition, healthy status and energy balance

A new device for measuring resting energy expenditure (REE) in healthy subjects.

Lifestyle change targeted towards increasing daily resting energy expenditure (REE) is one of the cornerstones of obesity treatment. Measurements of energy expenditure and substrate utilization are essential to understanding the metabolic basis of obesity, and the physiological responses to perturbations in habitual food intake. REE is the largest part of human energy expenditure (60-70%) and an increase or decrease in REE would have a large impact on total energy. Accurate and easy-to-use methods for measuring REE are needed, to be applied by clinicians in daily clinical settings to assess the validity of a new instrument to estimate REE in normal weight, healthy adults. METHODS: Ninety-nine subjects (52 females and 47 males) (mean+/-SD, age 38+/-14 years; body mass index (BMI) 23+/-3 kg/m(2)) were tested. REE was assessed using a Sensor Medics Vmax metabolic cart with a ventilated canopy and with the SenseWear armband. Body composition, percentage fat mass (%FM) and percentage fat free mass (%FFM) were assessed by skinfold thickness measurements (SF), bio-electrical impedance analysis (BIA) and air displacement plethysmography (BOD-POD). RESULTS: No significant difference was found among measurements of FFM using the three different techniques. Both SenseWear and Sensor Medics Vmax showed a high correlation, r=0.42 and r=0.40 (p<0.0001) respectively, with BMI. No significant difference was found in mean REE between SenseWear (1540+/-280 kcal/day) and Sensor Medics Vmax (1700+/-330 kcal/day) (p=ns) and the correlation between REE measured by SenseWear and Sensor Medics Vmax was high (r=0.86, p<0.0001). Bland-Altman plot showed no difference in REE determination between SenseWear and Sensor Medics Vmax. %FFM determined by BOD-POD correlated with SenseWear (r=0.42, p<0.0001) as well as Sensor Medics Vmax (r=0.38, p<0.001). CONCLUSION: SF, BIA and BOD-POD provide valid and reliable measurements of FFM. Our results suggest that the SenseWear armband is an acceptable device to accurately measure REE in healthy subjects. Its characteristics have the potential to reduce measurement times and make the SenseWear armband useful for epidemiological studies

Body composition and nutritional habits in professional ballet dancers

Object of this study was the analysis of fat mass (FM), fat free mass (FFM) and nutritional habits in professional ballet dancers. Our secondary aim was to evaluate daily energy intake and to compare nutritional habits with level of daily recommended assumption (LARN) or recommended dietary allowance (RDA). Twelve ballet dancers (7 males and 5 females), aged between 23-42 were studied. All the subjects trained at least 5 hours per day (8±3 hours).We used four different techniques to asses body composition: skinfold thickness measurements (TH), bioimpedance analysis (BIA) air displacement pletismography (BOD-POD) and dual energy X-ray absorptiometry (DXA). The latter was considered as a criterion method. FM using DXA was 6.2±2.0 kg and FFM 56.3±12.4 kg in the total population. FM was 5.2±1.1 kg and 6.9±2.3 kg in females and males using DXA, respectively. FFM in females was 44.6±4.8 kg and 64.7±8.2 kg in males. Correlation between FM derived by skinfolds Vs FM measured by DXA was significantly higher (p = 0.90) than between FM estimated by BIA (p = 0.54) and by BOD-POD (p = 0.48). Positive correlations were found between DXA FFM measurements and FFM anthropometric (p = 0.99), between DXA FFM and FFM estimated by BIA (p = 0.98) and between FFM measured by BOD-POD (p = 0.99). Total energy intake in male subjects was less than LARN or RDA recommendation (2464±256 Vs 3100±379 cal/day). On the other hand, total energy intake in female subjects was slightly higher than LARN or RDA recommendation (2439±391 Vs 2120±130 cal/day). This was probably due to a higher energy assumption from lipids in female subjects (32±7% in males Vs 36±7% in females). Our results may suggest that FM estimated by anthropometry could be preferred to BIA in this specific population, possibly because the main part of FM in this specific population is only subcutaneous

Ruptured Brain Arteriovenous Malformations: Surgical Timing and Outcomes-A Retrospective Study of 25 Cases

Background One important problem in treatment of ruptured brain arteriovenous malformations (bAVMs) is surgical timing. The aim of the study was to understand which parameters affect surgical timing and outcomes the most. Materials and Methods Between January 2010 and December 2018, 25patients underwent surgery for a ruptured bAVM at our institute. Intracerebral hemorrhage (ICH) score was used to evaluate hemorrhage severity, while Spetzler-Martin scale for AVM architecture. We divided patients in two groups: early surgery and delayed surgery. The modified Rankin Scale (mRS) evaluated the outcomes. Results Eleven patients were in the early surgery group: age 38 ± 18 years, Glasgow Coma Scale (GCS) 7.64 ± 2.86, ICH score 2.82 ± 0.71, hematoma volume 45.55 ± 23.21 mL. Infratentorial origin of hemorrhage was found in 27.3% cases; AVM grades were I to II in 82%, III in 9%, and IV in 9% cases. Outcome at 3 months was favorable in 36.4% cases and in 54.5% after 1 year. Fourteen patients were in the delayed surgery group: age 41 ± 16 years, GCS 13.21 ± 2.39, ICH score 1.14 ± 0.81, hematoma volume 29.89 ± 21.33 mL. Infratentorial origin of hemorrhage was found in 14.2% cases; AVM grades were I to II in 50% and III in 50%. Outcome at 3 months was favorable in 78.6% cases and in 92.8% after 1 year. Conclusions The early outcome is influenced more by the ICH score, while the delayed outcome by Spetzler-Martin grading. These results suggest that it is better to perform surgery after a rest period, away from the hemorrhage when possible. Moreover, this study suggests how in young patient with a high ICH score and a low AVM grade, early surgery seems to be a valid and feasible therapeutic strategy

Intramedullary non-specific inflammatory lesion of thoracic spine: A case report

<p>Abstract</p> <p>Background</p> <p>There are several non-neoplastic lesions which mimick intramedullary spinal cord neoplasm in their radiographic and clinical presentation. These can be classified as either infectious (TB, fungal, bacterial, parasytic, syphilis, CMV, HSV) and non-infectious (sarcoid, MS, myelitis, ADEM, SLE) inflammatory lesions, idiopathic necrotizing myelopathy, unusual vascular lesions and radiation myelopathy. Although biopsy may be indicated in many cases, an erroneous diagnosis of intramedullary neoplasm can often be eliminated pre-operatively.</p> <p>Case description</p> <p>the authors report a very rare case of intramedullary non-specific inflammatory lesion of unknown origin, without signs of infection or demyelinization, in a woman who showed no other evidence of systemic disease.</p> <p>Conclusions</p> <p>Intramedullary lesions that mimick a tumor can be various and difficult to interpret. Preoperative MRI does not allow a certain diagnosis because these lesions have a very similar signal intensity pattern. Specific tests for infective pathologies are useful for diagnosis, but histological examination is essential for establishing a certain diagnosis. In our case the final histological examination and the specific tests that we performed have not cleared our doubts regarding the nature of the lesion that remains controversial.</p

Deep Eutectic Solvents: Promising Co-solvents to Improve the Extraction Kinetics of CyMe4-BTBP

In this communication, we report on the use of deep eutectic solvents (DESs) for processing nuclear waste, with a view to selectively recovering minor actinides (MA) from highly active raffinate solutions. DESs are an interesting new class of green and eco-sustainable solvents. Herein, a representative family of DES was tested as a co-solvent for MA/lanthanides partitioning based on Selective ActiNide EXtraction (SANEX)-like hydrometallurgical processes. The reference system exploits the CyMe4-BTBP lipophilic extractant for selective MA recovery, but the slow kinetics is the main limitation toward the industrial implementation. A selection of hydrophilic DESs has been proposed as a phase transfer catalyst and tested to improve the process performances. In this work, the radiochemical stability and the extraction behavior of these DESs have been ascertained. Moreover, a preliminary optimization of system composition has been achieved. This study underlines a catalytic effect of DES that can be proficiently exploited to enhance CyMe4-BTBP extraction and selectivity

Process for extracting and purifying chitin by using green solvents

Process for the treatment of biomass comprising chitin with a process solvent selected from a eutectic solvent consisting of a hydrogen bond acceptor and a hydrogen bond donor, an ionic liquid and/or a mixture of said eutectic solvent and said ionic liquid, said process comprising the following steps: A. mixing the biomass with the process solvent; B. separating the chitin precipitated in step A. from the remainder of the mixture; wherein: i. the hydrogen bond acceptor is a choline salt with a C2-C6 organic acid, and containing at least one carboxyl group and optionally substituted in the alkyl chain with at least one hydroxyl group, ii. the hydrogen bond donor is an organic acid selected from: glycolic acid, diglycolic acid, levulinic acid, or is imidazole; provided that when choline glycolate is used as a hydrogen bond acceptor, the hydrogen bond donor must be different from glycolic acid; iii. in step A. a polar protic solvent soluble in both said process solvent and water is added to the process solvent; selected from a linear or branched C1-C6 aliphatic alcohol; iv. the ionic liquid is the salt resulting from the exchange reaction between one of the organic acids used as a hydrogen bond donor listed above in point ii. and a choline salt specified in i. used as a hydrogen bond acceptor