1,720,982 research outputs found
Il mucocele del seno sfenoidale, una rara complicanza a lungo termine della chirurgia ipofisaria : descrizione di un caso clinico
No full text
Serum Insulin-like Growth Factor I (IGF-1), functional ability and cognitive status in centenarians and centenarians' offspring
No full textEffetto del percorso riabilitativo multidisciplinare nel paziente anziano obeso
No full textScopo. L’obesità e le sue complicanze cliniche e metaboliche rappresentano
una condizione clinica sempre più frequente nel paziente anziano con importanti
implicazioni nell’aspettativa di vita e nella autonomia funzionale.
Il paziente anziano obeso ha un rischio aumentato di sviluppare diabete,
ipertensione e malattie cerebrovascolari con conseguente aspettativa di vita ridotta rispetto all’anziano normopeso. Inoltre, l’obesità determina una ridotta autonomia funzionale inversamente proporzionale all’eccesso ponderale. Attualmente non esistono terapie farmacologiche realmente
efficaci per il trattamento dell’obesità e le controindicazioni dei farmaci a
disposizione ne limitano l’uso nel paziente anziano. La terapia chirurgica è
frequentemente improponibile per i rischi intra e post operatori. Nel paziente
obeso non anziano la terapia educativo–comportamentale con approccio
multidisciplinare ha dato importanti risultati sull’entità del calo ponderale
e sul suo mantenimento nel tempo. Scopo dello studio è valutare l’efficacia
dell’approccio multidisciplinare nel paziente anziano obeso.
Materiali e metodi. 93 pazienti obesi anziani (14 M, 79F; età media ± DS:
69 ± 3.12 anni) sono stati sottoposti a percorso educativo-comportamentale per un periodo di tre mesi. Il percorso prevedeva almeno un incontro settimanale nel corso del quale venivano effettuate le seguenti valutazioni: misurazione dei parametri clinici e antropometrici, visita endocrinologica, dietistica, psicologica ed eventualmente psichiatrica con colloqui individuali e di gruppo. Inoltre, ad ogni incontro, i pazienti effettuavano un’ora di attività fisica aerobica in palestra. All’inizio e alla fine del percorso riabilitativo ai pazienti venivano effettuati: OGTT per glicemia ed insulina (escluso i diabetici noti), colesterolo HDL, LDL, trigliceridi, bioimpedenziometria per
analisi della percentuale di massa grassa e massa magra.
Risultati. Dopo il percorso educativo-comportamentale è stato osservato un significativo decremento del valore medio di BMI (36.6 vs 34.8 kg/m2, p<0.0001), circonferenza vita (115 vs 110 cm, p<0.0001), homa IR (2.5 vs 2.1, p<0.05), massa grassa (49.6 vs 47.5%, p<0.001), PA sistolica (136.8 vs 127 mmHg, p<0.001) e un significativo incremento della massa magra
(50.4 vs 52.5%, p<0.001). Un decremento quasi al limite della significatività
statistica è stato osservato per i livelli di glicemia al termine del percorso
multidisciplinare.
Conclusioni. Nel paziente anziano obeso il percorso educativo-comportamentale consente di ottenere una significativa riduzione dei parametri antropometrici e metabolici
Serum insulin-like growth factor I (IGF-I) : functional ability and cognitive status in centenarians and centenarians offspring
No full textSeveral evidences suggest that IGF-I system regulates healthy aging and human longevity. While in animal models alterations of IGF-I signalling increase the life expectancy, in humans there are few contradictory data on this topic. Low levels of serum IGF-I have been detected in populations of centenarians and have protective effects on the risk of several cancers in the general population. On the other hand, in the elderly population relatively high circulating IGF-I levels are associated with a decrease in cardiovascular morbidity and mortality. Centenarians are an extraordinary model to study human longevity and to identify their biological determinants. However, there are several inherent disadvantages in the study of centenarians: rarity, presence of frailty due to extreme age and lack of a control group of the same age. The presence of an age-matched control group is crucial in studies evaluating IGF system, considering that age influences IGF-I production. Centenarians' offspring, for whom it is possible to identify an appropriate control group (subjects of the same age born from non long-lived parents), appear to be a new and promising model of human longevity, showing a higher probability to became long-living. The aim of the present study was to evaluate the role of IGF-I in the modulation of functional ability and cognitive status in elderly subjects, particularly in centenarians and in potentially long-living population. In Milan we recruited: 48 centenarians; 28 centenarians' offspring born from one centenarian parent (O150), 21 centenarians' offspring born from both long-lived parents, one centenarian and the other long-lived (O250); 21 control subjects who do not have long-lived parents. In all subjects we evaluated serum IGF-I levels, self-sufficiency and autonomy (Activities of Daily Living: ADL; Instrumental Activities of Daily Living: IADL) and cognitive ability (Mini Mental Status Examination: MMSE; Mini Mental Status Examination corrected for age and education: MMSEc. IGF-I was significantly lower in centenarians (p<0.001) compared to controls. No significant differences in age and serum IGF-I levels were found between O150, O250 and controls. ADL, IADL, MMSE and MMSEc resulted to be significantly lower (p<0.001) in centenarians than in controls, while no significant differences were observed for all previous parameters between O150, O250 and controls. In the pooled groups IGF-I positively correlated with ADL (r=0.38, p<0.0001), IADL (r=0.42, p<0.0001), MMSE (r=0.40, p<0.0001) and MMSEc (r=0.30, p=0.001). In conclusion, these data suggest that IGF-I system may play an important protective role in the age-related decline of cognitive performance and functional ability
Thyroid nodules in acromegaly : the role of elastography
No full textIntroduction: Ultrasound elastography (US-E) is a helpful tool for the diagnosis of thyroid cancer. In acromegaly, multinodular goiter is a common occurrence while the prevalence of thyroid cancer is still matter of debate. Our aims were to evaluate thyroid nodules in acromegaly and to assess the accuracy of US-E in providing information on their nature (benign vs. malignant) using cytological analysis as a reference. Materials and methods: US-E was performed in 25 patients with acromegaly (active in 10 cases, medically controlled in 8, and cured by pituitary surgery in 7), each of whom had at least one solid thyroid nodule. A total of 90 nodules were classified according to the elastography scores (ES): ES1 and ES2 for soft nodules, ES3 and ES4 for an elastic lesions. FNAC was performed in 78.6% of the ES 4 lesions and 54.1% of the ES 3 nodules. Results: Fourteen of the 90 nodules (15.5%) displayed an ES of 1, 25 (27.7%) an ES of 2, 37 (41.3%) an ES of 3, and 14 (15.5%) an ES of 4. The prevalence of hard nodules in patients with active acromegaly (68.9%) was greater than that observed in patients with cured (44.4%) or controlled (52.5%) acromegaly. The prevalence of hard nodules in the total series (56.7%) was higher than that reported in nonacromegalic goitrous subjects. All thyroid nodules subjected to FNAC were negative for malignant cells and follicular lesions. Discussion: Acromegaly (particularly active forms) is associated with a high prevalence of stiff thyroid nodules that exceeds that observed in nonacromegalic patients with goiters (33.7%). However, these nodules were never malignant at cytology, and their firmness is probably due to fibrosis. US-E therefore appears to be of limited value for the diagnosis of thyroid cancer in patients with acromegaly
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
- …
