74 research outputs found
Metabolic comorbidities of adrenal insufficiency: Focus on steroid replacement therapy and chronopharmacology.
No full textAdrenal insufficiency (AI) is characterized by higher mortality and morbidity compared with the general population. Conventional replacement steroid therapy, currently recommended for the treatment of AI, is associated with increased frequency of metabolic comorbidities due to daily overexposure. By contrast, dual-release hydrocortisone is associated with a decreased risk of metabolic comorbidities, providing an adequate release of hydrocortisone and mimicking the physiological profile of cortisol. These favorable effects are due to a reduced daily steroid exposure that does not affect the expression of the clock genes which are involved in metabolic pathways and are regulated by the normal physiological circadian rhythm of endogenous cortisol. This narrative review focuses on the possible metabolic comorbidities of AI due to steroid replacement therapy, which evaluates the effects of conventional and novel drugs with attention to chronopharmacology
Very Low-Calorie Ketogenic Diet: A Potential Application in the Treatment of Hypercortisolism Comorbidities
No full textA very low-calorie ketogenic diet (VLCKD) is characterized by low daily caloric intake (less than 800 kcal/day), low carbohydrate intake (<50 g/day) and normoproteic (1-1.5 g of protein/kg of ideal body weight) contents. It induces a significant weight loss and an improvement in lipid parameters, blood pressure, glycaemic indices and insulin sensitivity in patients with obesity and type 2 diabetes mellitus. Cushing's syndrome (CS) is characterized by an endogenous or exogenous excess of glucocorticoids and shows many comorbidities including cardiovascular disease, obesity, type 2 diabetes mellitus and lipid disorders. The aim of this speculative review is to provide an overview on nutrition in hypercortisolism and analyse the potential use of a VLCKD for the treatment of CS comorbidities, analysing the molecular mechanisms of ketogenesis
L'architettura delle opere di difesa del suolo come rafforzamento dei caratteri identitari del paesaggio
No full textL’ARCHITETTURA DELLE OPERE DI DIFESA DEL SUOLO COME RAFFORZAMENTO DEI CARATTERI IDENTITARI DEL PAESAGGIO
La ricerca è incentrata sul valore che le architetture delle opere di difesa dai rischi assumono rispetto ai luoghi urbani e ai loro paesaggi aperti, intesi come "patrimonio" identitario da salvaguardare e valorizzare.
Attraverso la ricerca si vuole mettere a punto e definire un metodo, che per analogia, indaga sui modi attraverso cui si riconoscano le buone pratiche o anche le criticità rispetto all’esperienza progettuale dell’architettura.
La tesi è composta e si divide in tre parti.
La prima parte fissa i temi d’approccio alla ricerca indagando sulle condizioni di fragilità dei territori legati al tema del rischio idrogeologico, e sui caratteri formali e espressivi assunti delle opere di difesa.
La seconda parte ricerca invece tenta di definire attraverso un approccio morfologico, la relazione implicita che le scienze dure e le forme tecniche stabiliscono con le forme fisiche, rendendo questa relazione più evidente attraverso il disegno. Questo aspetto propedeutico al lavoro sul progetto si pone a metà tra la geografia fisica e l’ingegneria idraulica, e cerca di rendere più evidenti i legami morfologici tra le forme tecniche e le forme orografiche.
La terza parte mette a punto un metodo per analogia, che definisca un metodo attraverso l’esperienza sul progetto della messa in sicurezza dal rischio idrogeologico, svolta nel dominio dell’architettura. Si tenta di esplicitare le forme fisiche e le forme tecniche descritte nella seconda parte con l’interpretazione e la definizione formale del progetto di architettura, basati sui principi definiti in ambito teorico e validati attraverso l’applicazione progettuale.
Nello specifico i progetti scelti tentano di risolvere il problema di riuscire a convivere con la condizione dell’inondazione, nella definizione di forme che possono accompagnare la dinamica della trasformazione.
Il riconoscimento delle operazioni architettoniche, prova a dare attraverso un ragionamento sulle forme, principi di adeguatezza o di inappropriatezza sul valore di queste opere.
In questa prospettiva il progetto di messa in sicurezza viene considerato, piuttosto che come un insieme di "rimedi" puntuali slegati tra loro, come una opportunità di ripensamento e ridefinizione del paesaggio a scala urbana e territoriale. Attraverso il progetto mitigativo si vuole cogliere allora l'occasione per ripensare e rinnovare la forma di questi paesaggi, esaltando i loro caratteri identitari, e trasformandoli in luoghi sicuri, protetti e fruibili.THE ARCHITECTURE OF SOIL DEFENSE WORKS AS A STRENGTHENING OF THE IDENTITY CHARACTERS OF THE LANDSCAPE
The research focuses on the value that the architectures of risk-defending works assume with respect to urban places and their open landscapes, understood as identity "heritage" to be safeguarded and enhanced.
The research aims to develop and define a method, which by analogy, investigates the ways in which good practices or even critical issues with respect to the project experience of architecture are recognized.
The thesis is composed and is divided into three parts.
The first part sets out the research approach themes by investigating the fragile conditions of the territories linked to the theme of hydrogeological risk, and the formal and expressive characteristics assumed of the defense works.
The second part of the research instead attempts to define through a morphological approach, the implicit relationship that hard sciences and technical forms establish with physical forms, making this relationship more evident through drawing. This preparatory aspect to the work on the project is halfway between physical geography and hydraulic engineering, and seeks to make more evident the morphological links between technical forms and orographic forms.
The third part develops a method by analogy, which defines a method through the experience on the project of safety from hydrogeological risk, carried out in the domain of architecture. An attempt is made to explain the physical forms and technical forms described in the second part with the interpretation and formal definition of the architectural project, based on the principles defined in the theoretical field and validated through the project application.
Specifically, the projects chosen attempt to solve the problem of being able to live with the condition of flooding, in the definition of forms that can accompany the dynamics of the transformation.
The recognition of architectural operations, tries to give through an argumentation on the forms, principles of adequacy or inappropriateness on the value of these works.
In this perspective, the safety project is considered, rather than as a set of punctual "remedies" unrelated to each other, as an opportunity for rethinking and redefining the landscape on an urban and territorial scale. Through the mitigating project, we want to take the opportunity to rethink and renew the shape of these landscapes, enhancing their identity characteristics, and transforming them into safe, protected and usable places
Cognitive impairment in subclinical hypothyroidism (SCH) effect of L-Thyroxine (LT4)administration
No full textA vector spline approximation
No full textAbstractWe introduce a new family Pα,β of spline minimization problems for vector fields, defined by where V = (u, v) is a two component vector function, X is the Beppo-Levi space D−2L2(R2) x D−2L2(R2), Xi = (xi, yi are the interpolation points, and Vi = (ui, vi) are data values. A coupling between V components is achieved by the divergence (div) and rotational (rot) operators. α, β are fixed real positive constants controlling the relative weight on the gradient of the divergence and rotational fields. The explicit control on divergence and rotational operators is well suited for geophysical fluid flow interpolations; it allows us to cope with the great differences frequently observed in the magnitudes of the divergent and rotational parts of the flow. Through the general spline formalism, existence and uniqueness of the solution is proved. The analytical solution is explicitly calculated and numerical examples are presented. For α (and β) → 0, “limit” problems are defined and their analytical solutions are given
MANAGEMENT AND TREATMENT OF TASTE AND SMELL ALTERATIONS IN ONCOLOGIC PATIENTS UNDERGOING ANTITUMORAL THERAPY AND RADIOTHERAPY
No full textManagement and treatment of taste and smell alterations in oncologic patients undergoing antitumoral therapy and radiotherapy
No full textObjective: The objective of this review is to investigate strategies to manage and treat taste and smell alterations in oncologic patients to minimize the effect these have on their quality of life and their nutritional model as well.Materials and Methods: A scoping review was conducted, and the following international databases were consulted: PubMed, CINAHL, Cochrane, and Scopus. The scoping review process was conducted using Arksey & O'Malley's framework.Results: A total of 18 studies were considered relevant and were divided into three macro areas: pharmacological interventions, aimed to manage and treat taste and smell alterations; non-pharmacological interventions and self-care strategies to adapt oneself as to not perceive the information provided by these senses and to accept the current situation as no reparatory interventions are available.Conclusions: Both dysgeusia and dysosmia require complex evaluations, the etiopathogenesis mechanisms are not yet completely known and there are no universal evaluation instruments available. A precocious evaluation of these symptoms needs to include the physical, psychological, and social spheres of patients. Healthcare staff plays a key role as they link the primary care and home care of these symptoms. Taste and smell disturbances are underestimated and are not the focus of enough studies, and it is, therefore, desirable that the future holds an enlargement in the number of studies regarding aetiology, objective and subjective evaluation, and application of interventions to prevent, treat and manage these symptoms
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