1,354,419 research outputs found
Personalized multistep cognitive behavioral therapy for obesity
No full textRiccardo Dalle Grave, Massimiliano Sartirana, Marwan El Ghoch, Simona Calugi Department of Eating and Weight Disorders, Villa Garda Hospital, Verona, Italy Abstract: Multistep cognitive behavioral therapy for obesity (CBT-OB) is a treatment that may be delivered at three levels of care (outpatient, day hospital, and residential). In a stepped-care approach, CBT-OB associates the traditional procedures of weight-loss lifestyle modification, ie, physical activity and dietary recommendations, with specific cognitive behavioral strategies that have been indicated by recent research to influence weight loss and maintenance by addressing specific cognitive processes. The treatment program as a whole is delivered in six modules. These are introduced according to the individual patient’s needs in a flexible and personalized fashion. A recent randomized controlled trial has found that 88 patients suffering from morbid obesity treated with multistep residential CBT-OB achieved a mean weight loss of 15% after 12 months, with no tendency to regain weight between months 6 and 12. The treatment has also shown promising long-term results in the management of obesity associated with binge-eating disorder. If these encouraging findings are confirmed by the two ongoing outpatient studies (one delivered individually and one in a group setting), this will provide evidence-based support for the potential of multistep CBT-OB to provide a more effective alternative to standard weight-loss lifestyle-modification programs. Keywords: obesity, cognitive behavioral therapy, lifestyle modification, weight loss, weight maintenance, outcom
Long-term weight loss maintenance for obesity: a multidisciplinary approach
No full textLuca Montesi,1 Marwan El Ghoch,2 Lucia Brodosi,1 Simona Calugi,2 Giulio Marchesini,1 Riccardo Dalle Grave2 1Unit of Metabolic Diseases, S Orsola-Malpighi Hospital, “Alma Mater Studiorum” University, Bologna, Italy; 2Department of Eating and Weight Disorders, Villa Garda Hospital, Verona, Italy Abstract: The long-term weight management of obesity remains a very difficult task, associated with a high risk of failure and weight regain. However, many people report that they have successfully managed weight loss maintenance in the long term. Several factors have been associated with better weight loss maintenance in long-term observational and randomized studies. A few pertain to the behavioral area (eg, high levels of physical activity, eating a low-calorie, low-fat diet; frequent self-monitoring of weight), a few to the cognitive component (eg, reduced disinhibition, satisfaction with results achieved, confidence in being able to lose weight without professional help), and a few to personality traits (eg, low novelty seeking) and patient–therapist interaction. Trials based on the most recent protocols of lifestyle modification, with a prolonged extended treatment after the weight loss phase, have also shown promising long-term weight loss results. These data should stimulate the adoption of a lifestyle modification-based approach for the management of obesity, featuring a nonphysician lifestyle counselor (also called “lifestyle trainer” or “healthy lifestyle practitioner”) as a pivotal component of the multidisciplinary team. The obesity physicians maintain a primary role in engaging patients, in team coordination and supervision, in managing the complications associated with obesity and, in selected cases, in the decision for drug treatment or bariatric surgery, as possible more intensive, add-on interventions to lifestyle treatment. Keywords: obesity, lifestyle modification, cognitive behavior therapy, multidisciplinary treatmen
Un'analisi del consumo alimentare in Italia:profili di espansione sui mercati esteri e strumenti finanziari di sostegno e copertura
No full textFlow cytometric and cytogenetic analyses in human spontaneous-abortions
No full textCytogenetic and flow cytometric analyses were performed on 38 human spontaneous abortions in an attempt to obtain information on karyotype abnormalities and to compare the two approaches of analysis. In 19 cases, it was not possible to perform cytogenetic analysis because too long a time had passed between surgical sampling and cell culture, and in vitro culture failed. Of the 19 cases analyzed, 10/19 showed a normal karyotype and 5/19 showed a single trisomy (2/5 trisomies involved chromosome 16, 115 trisomy involved chromosome 18. 1/5 trisomy involved chromosome 20, and 1/5 was Klinefelter syndrome). Of the remaining 4/19 cases, 2/19 showed a polyploid condition (1 tetraploidy and 1 triploidy), 1/19 a double trisomy (chromosomes 13 and 21), and 1/19 a pentasomy of the sex chromosomes (49,XXXXY). Flow cytometric analysis was performed on all abortive samples. The samples were subdivided, when possible, into two portions conventionally named ''amniotic'' and ''chorionic'', using the amniotic membrane as an anatomical reference. Maternal blood lymphocytes were used as a diploid standard for each sample. In the 19 cases not analyzed by the cytogenetic approach, flow cytometric analysis showed 9 diploid and 10 aneuploid DNA distributions. In the remaining 19 cases, analyzed with both approaches, the comparison of DNA estimations using cytogenetic and flow cytometric analyses showed good agreement. In the cases with karyotype abnormalities, flow cytometric measurement provided evidence of an alteration of DNA content with respect to the diploid standard. Flow cytometric analysis showed a diploid distribution, whereas cytogenetic analysis revealed chromosomal abnormalities in only 4/19 cases. These discordant results could be related to mosaic conditions or maternal cell contamination, Moreover, cytogenetic and flow cytometric analyses were performed on 2 amniotic cell cultures, and concordant results were obtained. The results obtained suggest that a combination of these techniques is beneficial in attempts to obtain information about DNA content alterations, even when cultures fail, and in screening studies of human abortions
Cellular effects of diagnostic doppler ultrasound on murine spermatogenic cells monitored by flow-cytometry
No full textA study has been carried out to investigate the possible effects caused by Doppler diagnostic ultrasound on murine spermatogenesis. The frequency of the different types of cells has been analyzed using flow cytometry. Exposure to ultrasound was carried out using a commercial device used in diagnostic conditions. Male hybrid mice were exposed to ultrasound for 30 min and observed from 7 to 35 days after treatment. Flow cytometrical analysis showed changes in the relative frequency of the elongated spermatids and this was used as an end-point. A statistically significant decrease in the frequency of this cell type was observed after 7 and 35 days with both pulsed and continuous ultrasound. With the former, a decrease was also seen in this compartment after 14 and 21 days. Our results have shown that diagnostic ultrasound used in the Doppler technique induces effects on specific cell types of murine spermatogenesis
Un percorso di amministrazione condivisa: il caso dell’emporio solidale di Empoli
No full textL’amministrazione condivisa si fonda sul dialogo costante tra Enti del Terzo settore e Pubblica amministrazione, che rende possibile una più ampia capacità di intercettare e comprendere i bisogni della collettività. Questo è il senso dell’art. 55 del d. lgs. 117/2017 (Codice del Terzo settore) che disciplina i procedimenti di co-programmazione e di co-progettazione, ispirati al principio di sussidiarietà orizzontale (art. 118, 4 comma, Cost.), come rimarcato anche dalla sentenza della Corte costituzionale 131/2020. Per comprendere a pieno le potenzialità applicative dell’istituto, si è scelto di procedere allo studio di un caso concreto: quello
dell’Emporio solidale di Empoli
Su un caso clinico di torsione uterina in gravidanza
No full textThe Authors report a case of classic cesarean section through the posterior uterine wall because of a uterine torsion with failure of restitution at 31st week of pregnancy, abruptio placentae, premature rupture of the membranes and partial septate uterus. The uterine torsion is a very rare complication in pregnancy, but it is associated with serious fetal and maternal consequences
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