Hematocrit Values Predict Carotid Intimal-Media Thickness in Obese Patients With Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study

BACKGROUND: Literature data suggest with some criticism that full-fledged cardiovascular (CV) events (acute or chronic) are likely predicted by blood components, which are reported to be associated with the presence/severity of non-alcoholic fatty liver disease (NAFLD). This study was aimed at determining which marker(s) derived from blood count, such as white blood cells, neutrophils, neutrophil/lymphocyte ratio, platelet count, hemoglobin, mean corpuscular volume, hematocrit values were associated with ear or subclinical atherosclerosis, in obese patients of various classes suffering from NAFLD. METHODS: One hundred consecutive obese patients presenting NAFLD at ultrasound, with low prevalence of co-morbidities and no history or instrumental features of CV diseases, underwent carotid intima-media thickness (IMT) assessment by Doppler ultrasonography. All of them were studied taking into account anthropometric parameters, the metabolic profile, and inflammatory markers. RESULTS: White blood cells and neutrophil count showed no statistical association with IMT, which was predicted by the amount of visceral adiposity, as appreciated by ultrasonography. After adjusting for visceral adiposity and smoking status, only age and hematocrit contextually predicted early atherosclerosis, evaluated as IMT. Visceral adiposity was a confounding factor in foreseeing IMT. CONCLUSION: Hematocrit values along with the patient's age suggest an initial atherosclerosis, evaluated as IMT, and if this finding is confirmed in larger cohorts, could be added to other canonical CV risk factors. Inferences can be enhanced by future prospective studies that aim to identify the relationships between incident cardio-metabolic cases and this hematologic parameter

Waste recovery and circular economy: a resource from orange peels deriving from production of orange juice

In the perspective of bio-sustainable development and renewable resource technologies, by-products and waste from agro-industrial sector represent a relatively cheap source of material suitable for several aims, which would reduce both the amount of waste and the related costs of disposal, while producing added-value nutritional products. The processing waste of oranges find various fields of application, in fact in addition to their use in agriculture as a fertilizer, orange peels can be used to produce candied fruit. Moreover, in a very recent application with the aim to recover these industrial residues, a chemical process that allows the processing of orange peel waste has been developed. This process is useful for obtaining a purified cellulose suitable for spinning, thus creating a truly innovative and sustainable fabric (Orange Fiber). In this work, the orange peels obtained from industrial processing waste were subjected to a first hydroalcoholic extraction which allowed to obtain an extract rich in essential oils that could be used in the food sector to produce liqueurs and/or aromas, but also in the cosmetic or pharmacological sectors. Subsequently, the peels after hydroalcoholic extraction were dried and this residue represents a valuable product rich in dietetic fiber useful in nutraceutical and pharmaceutical fields. Moreover, the same product could be used as fertilizer in agriculture. In lights of this, citrus fruit processing waste can be considerate as a sustainable and renewable energy source

Various applications of processing of olive leaves waste extracted with RSLDE: a green technology

There is no waste in nature. Everything that is produced has a purpose and everything that becomes waste can be transformed into a new resource, triggering a virtuous circuit that feeds itself. The circular economy of waste means a system in which the production-consumption-disposal process is overcome to replace it with a circular model, where the final waste product is re-introduced into the circulation as a secondary raw material. The logic to follow is that after consumption and before any disposal, it is necessary to activate virtuous processes such as reduce, reuse and recycling. This work focuses on the possible uses of a vegetable waste matrix, such as olive leaves. The olive tree (Olea europaea) is a fruit tree, cultivated for more than 3,500 years for its fruits and edible oil. However, just like oil, olive leaf contains a high amount of polyphenols, in particular oleuropein, one of the most powerful natural antioxidants known and hydroxytyrosol, which also has powerful antiseptic properties. Therefore, olive leaf extracts, thanks to the presence of oleuropein associated with hydroxytyrosol, represent a powerful natural antioxidant, a valid ally of the cardiovascular system. In addition, olive leaves are an excellent regulator of the digestive system: they regulate intestinal transit and above all eliminate fungi and other unwanted parasites from our body. Starting from these premises, in this work, a green extraction technique such as rapid solid liquid dynamic extraction (RSLDE) is compared with conventional maceration to obtain an olive leaf extract rich in antioxidants to be used in various sectors

Extraction and purification of phycocyanin from Arthrophira platensis microalgae using a green solid-liquid extraction technology (RSLDE)

Abstract. Spirulina is a blue alga belonging to the class of Cyanobacteria. This alga is characterized by a high content of phycocyanin, a blue photosynthetic pigment belonging to the phycobiliprotein family. Phycocyanin has a lot of industrial applications, in fact, it is used as a natural dye both in the cosmetic industry and in the food and textile sectors. It is also used in the biomedical field as a fluorescent marker. Anti-inflammatory, nephroprotective and hepatoprotective properties are also reported, probably related to its antioxidant activity. However, the extraction of phycobiliproteins from cyanobacteria is a very complicated procedure due to the extreme resistance of the wall of the cellular aggregates that make up spirulina. In literature, several procedures have been used to cause rupture of cell envelopes, through cycles of freezing/thawing, sonication and rupture of the cell wall with lysozyme. However, all these methods for cell breakdown do not guarantee a high quality of the extract, due to the complexity of the mixture obtained. In order to improve the yield of recovery of phycocyanin and to reduce the extraction process time, in this work, in combination with some experimental procedures for rupture of the membrane, a green extraction technique was used, the rapid solid liquid dynamic extraction (RSLDE). This technique can generate a pressure and a consequent depression on the matrix to be extracted. The extract obtained was immediately frozen at -20°C and then lyophilized. Analyzes such as UV-VIS spectrophotometric analysis and acrylamide gel electrophoresis were performed on the sample of lyophilizate to evaluate the efficiency of the extraction and purity of phycocyanin

Eustachian tube dysfunction in children with adenoid hypertrophy: the role of adenoidectomy for improving ear ventilation

Introduction: To our knowledge, few papers have addressed preoperative evaluation of the impact of adenoid hypertrophy (AH) on the pathogenesis of eustachian tube dysfunction (ETD) in children with otitis media with effusion (OME). Aim: The aim of this study was 2-fold: first, to evaluate ETD using tubomanometry and Eustachian Tube Score 7 (ETS-7), in a group of children having AH; second, to assess the clinical impact of adenoidectomy on the ETD of these patients. Methods: Fifty patients, aged 4 to 15 years, underwent adenoidectomy based on various parameters: size of the adenoids causing canal obstruction (grades 1-4), the presence of OME, and recurrent episodes of rhinosinusitis. The function of the eustachian tube was evaluated using ETS-7 before and after surgical treatment. The patients were followed up for 6 months. Results: Forty children presented ETD. Of these, 36 had a grade 4 AH. The preoperative mean value for ETS-7 was 6.62. The mean postoperative ETS-7 score showed a value of 9.60 with a statistical difference compared to the preoperative value (P =.0015). Conclusions: Adenoid hypertrophy has a high impact on the frequency of ETD. In the patients observed in the present study, the ETS-7 score appeared to be a valid tool for assessing ETD both preoperatively and postoperatively. Adenoidectomy seemed to be effective in improving ETD as well as middle ear ventilation

Polycystic Ovary Syndrome and Hepatic Steatosis: Could Low-Grade Chronic Inflammation Be Mediated by the Spleen?:

Polycystic Ovary Syndrome (PCOS) is characterized by an extreme variety of phenotypes and controversial metabolic implications. Hepatic Steatosis (HS) and low-grade chronic inflammation (LGCI) might be common findings in PCOS. We conducted a cross-sectional study to evaluate the LGCI and HS in young women with PCOS according to their Body Mass index (BMI), Insulin Resistance (IR), and PCOS phenotypes. Sixty young premenopausal PCOS women and 20 age-matched controls participated. Primary outcome measures were the presence/severity of HS; LGCI index evaluated as spleen longitudinal diameter (SLD) by UltraSound, C-Reactive Protein (CRP) and Interleukin (IL)-6 levels; BMI and the Homeostasis Model Assessment (HoMA) of IR. The second outcome measures were testosterone, Sex Hormone-Binding Globulin (SHBG) levels, and Free Androgen Index (FAI). The presence of HS and LGCI was not significantly different between NW and O/O patients, while there were significant differences particularly when the PCOS-women were grouped according to IR or to PCOS phenotypes. At multiple regression adjusted for BMI, HoMA-IR and the spleen size were the major determinants of the severity of HS (β= 0.36, p=0.007, and β= 0.28, p=0.034, respectively). At multiple regression SLD represented the unique predictor of FAI (β=0.32; p=0.018). In young women with PCOS, HS was detected independently from obesity and was well predicted not only by IR but also by spleen size, with variable expression of the liver-spleen axis across the different PCOS subtypes. A possible role of the spleen in determining LGCI also in women with PCOS is emphasized

Morbid obesity and thyroid cancer rate. A review of literature

In the past three decades, several recent studies have analyzed the alarming increase of obesity worldwide, and it has been well established that the risk of many types of malignancies is increased in obese individuals; in the same period, thyroid cancer has become the fastest growing cancer of all malignancies. We investigated the current literature to underline the presence of a connection between excess body weight or Body Mass Index (BMI) and risk of thyroid cancer. Previous studies stated that the contraposition between adipocytes and adipose-resident immune cells enhances immune cell production of multiple pro-inflammatory factors with subsequent induction of hyperlipidemia and vascular injury; these factors are all associated with oxidative stress and cancer development and/or progression. Moreover, recent studies made clear the mitogenic and tumorigenic action of insulin, carried out through the stimulation of mitogen-activated protein kinase (MAPK) and phosphoinositide-3 kinase/AKT (PI3K/AKT) pathways, which is correlated to the hyperinsulinemia and hyperglycemia found in obese population. Our findings suggest that obesity and excess body weight are related to an increased risk of thyroid cancer and that the mechanisms that combine overweight with this cancer should be searched for in the adipokine pathways and chronic inflammation onset

Vitamin D and neurological diseases: An endocrine view

Vitamin D system comprises hormone precursors, active metabolites, carriers, enzymes, and receptors involved in genomic and non-genomic effects. In addition to classical bone-related effects, this system has also been shown to activate multiple molecular mediators and elicit many physiological functions. In vitro and in vivo studies have, in fact, increasingly focused on the "non-calcemic" actions of vitamin D, which are associated with the maintenance of glucose homeostasis, cardiovascular morbidity, autoimmunity, inflammation, and cancer. In parallel, growing evidence has recognized that a multimodal association links vitamin D system to brain development, functions and diseases. With vitamin D deficiency reaching epidemic proportions worldwide, there is now concern that optimal levels of vitamin D in the bloodstream are also necessary to preserve the neurological development and protect the adult brain. The aim of this review is to highlight the relationship between vitamin D and neurological diseases

Carotid artery endarterectomy in patients with symptomatic non-stenotic carotid artery disease

Object We sought to determine the safety and efficacy in secondary stroke prevention of carotid endarterectomy (CEA) in patients with symptomatic non-stenotic carotid artery disease (SyNC). Methods This was a single-centre retrospective case series. All patients who underwent CEA for unilateral anterior circulation cerebrovascular events with ipsilateral <50% carotid stenosis from 2002 to 2020 were included. Imaging hallmarks including the degree of luminal stenosis and the presence of various vulnerable plaque characteristics (eg, intraplaque haemorrhage (IPH) on MR angiography, ulceration or low-density plaque on CT angiography) were assessed. The presence of vulnerable plaque characteristics was compared between arteries ipsilateral to the ischaemic event and contralateral arteries. The prevalence of perioperative/intraoperative complications, as well as recurrent ischaemic events at follow-up was determined. Results Thirty-two patients were included in the analysis, of which 25.0% were female. Carotid arteries ipsilateral to an ischaemic event had a significantly higher prevalence of IPH when compared with contralateral arteries (80.0% vs 0.0%; p<0.001). There were no intraoperative complications. One patient (3.1%) developed symptoms of transient ipsilateral ischaemia 1 day following CEA which resolved without treatment. In a median follow-up of 18.0 months (IQR 5.0-36.0), only one patient (3.1%) experienced a transient neurologic deficit with complete resolution (annualised rate of recurrent stroke after CEA of 1.5% for a total follow-up of 788 patient-months following CEA). All other patients (31/32, 96.9%) were free of recurrent ischaemic events. Conclusion CEA appears to be safe and well-tolerated in patients with SyNC. Additional studies with larger cohorts and longer follow-up intervals are needed in order to determine the role of CEA in this patient population