1,721,142 research outputs found
Gianluigi Zenti, President, Academia Barilla SpA - The Changing Consumer: Demanding but Predictable
Get PDFIt is crucial to understand and predict consumers' behaviour to meet future consumer demands. This report contributes to the discussion by giving an insight into consumers' behaviour from the perspective of Gianluigi Zenti, executive director of Academia Barilla. It is discussed how consumers' choice has changed in particular with regard to Italian food in the US and how Barilla has responded to that challenge.Consumer demand, consumer behaviour, Academia Barilla, Italian food, Consumer/Household Economics,
Effetti di diverse tecniche di Chirurgia Bariatrica sull’Omeostasi Metabolica in pazienti Obesi
Get PDFLa chirurgia bariatrica si è dimostrata efficace nel determinare la remissione del diabete tipo 2 nei soggetti obesi, tuttavia il meccanismo con cui le diverse tecniche chirurgiche agiscono sulla secrezione β-cellulare e sulla modulazione dell’insulino-resistenza non è ancora completamente chiarito.
Scopo: valutare in modo prospettico gli effetti di diverse tecniche di chirurgia bariatrica (bendaggio gastrico, sleeve gastrectomy, bypass gastrico) sul calo ponderale e sul compenso glicometabolico in pazienti obesi diabetici, e individuare, in un sottogruppo di questi pazienti, i meccanismi attraverso cui l’intervento di chirurgia bariatrica modifica l’omeostasi del glucosio.
Metodi: Sono stati arruolati 104 obesi diabetici, (66 F; 38 M) sottoposti consecutivamente a chirurgia bariatrica; 11 pazienti sono stati sottopostia a Bendaggio Gastrico Regolabile (LAGB) (età 47,3±2,9 anni; BMI 42,3±2,5 kg/m2), 77 a Bypass Gastrico (RYGB) (età 49.0± 0,1 anni; BMI 45,7±0,76 kg/m2) e 16 a Sleeve gastrectomy (SG) (età 50,0±2,3 anni; BMI 50,7±2,2 kg/m2). I pazienti erano eterogenei per durata di malattia e per trattamento antidiabetico.
5 soggetti (2M; 3F), età media 48,2±4,3 anni, peso 112,5±7,9 kg, BMI 40,9±2,7 kg/m2, durata di diabete: 5,6 anni (range 3-12 aa), HbA1c 7,6± 0,6%, sono stati sottoposti a test pasto-misto (186 Kcal: 53% carboidrati, 17% proteine, 30% grassi) prima e 1 mese dopo chirurgia (RYBP), con dosaggio di glicemia, C-peptide, insulina, lattato, e GIP per 5 ore. La funzione β-cellulare è stata valutata mediante analisi modellistica delle curve glucosio/C-peptide durante pasto e costruzione della curva stimolo (glicemia)-risposta (secrezione di insulina). La valutazione di massa grassa e massa magra negli arti e nel tronco, prima e 1 mese dopo chirurgia, è stata eseguita mediante DEXA.
Risultati: I 104 pazienti hanno presentato un calo ponderale medio a 12 mesi del 26,5±1,46 % che si è mantenuto a 24 e 36 mesi. La remissione del diabete a 36 mesi è stata evidenziata nel 56,5% dei pazienti (nel 50,0% dei pazienti sottoposti a LAGB, 56% dei pazienti sottoposti a RYGB, e 100% dei pazienti sottoposti a SG).
La durata di malattia è risultato l’unico predittore della persistenza del diabete a 24 e 36 mesi.
Nei 5 pazienti sottoposti a test con pasto misto (secondo protocollo pubblicato su ClinicalTrials.gov NCT 01767441), dopo un mese dall’intervento è stato evidenziato un significativo calo ponderale: Δmassa-totale -10,62±0,61 kg p<0,001, ΔBMI -4,07±0,26 kg/m2 p<0,001, Δgrasso-tot -5,58±0,74 kg p<0,007; Δgrasso del torso (-4,13±0,69 p<0,04). Dopo un mese dall’intervento, glicemia e insulina a digiuno calavano (glicemia 9,6±1,18 vs 5,5±0,47 mmol/L, p=ns; insulina 231,36±21,17 vs 64,92±4,41 pmol/L, p=0,02), come anche HOMA-IR (17,2±4,8 vs 2,7±0,61 p=0,04). Si riduceva inoltre l’area sotto la curva insulinemica (66,43±10.5 vs 28.67±7.4 nmol/l in 4 ore; p=0,039) e l’area sotto la curva del lattato (256,03±34,76 vs 183,77±32,89 mmol/l in 4 ore; p=0,02) mentre la risposta del GIP al pasto misto ha mostrato una tendenza all’aumento (AUC 19,14±5,14 vs 23,72±3,4 ng/ml in 4 ore, p=ns). Infine, la funzione β-cellulare migliorava significativamente (p<0.04) come dimostrato dallo spostamento a sinistra della curva stimolo-risposta.
Conclusioni: Nella maggior parte dei nostri pazienti, il calo ponderale dopo chirurgia bariatrica si mantiene fino a 3 anni di follow-up e la remissione completa del diabete a 3 anni riguarda oltre il 50 % dei diabetici, senza evidenza di recidive.
I dati preliminari del test pasto misto, dopo 30 giorni dall’intervento di RYBP, suggeriscono che il miglioramento dell’omeostasi glucidica sia attribuibile a concomitanti incrementi della funzione β-cellulare e della sensibilità insulinica, con contemporanea riduzione della glicolisi anaerobia. Tali miglioramenti sono ottenuti in presenza di una significativa riduzione dell’impegno biochimico della β-cellula.Bariatric surgery can lead to improvement or even resolution of type 2 diabetes Mellitus (T2DM) with the spectrum of responses depending also on operation procedures. However, many underlying mechanisms of metabolic action of different surgical techniques are still unclear.
The aim of this study was evaluate the long-term effects of bariatric surgery on weight loss and T2DM remission and to provide a better understanding of the effects of surgery on β-cell function and incretin secretion.
METHODS:
The study included 104 obese T2DM patients (66 women and 38 men, ) who were wait-listed for laparoscopic gastric banding (LAGB, 11 subjects, age 47,3±2,9 y, BMI 42,3±2,5 kg/m2), or for laparoscopic Roux-en-Y gastric bypass (RYBP , 77 subjects, age 49,7±0,1 y, BMI 45,7±0,7 kg/m2), or for sleeve gastrectomy (SG, 16 subjects, age 50,9±2,3 y, BMI 50,7±2,2 kg/m2)
In 5 patients a mixed meal tolerance test (MMT: 186 Kcal; 53% carbohydrate, 30% fat, 17% protein) was performed before and 1 and 12 months after RYBP to assess hormonal changes. During MMT blood samples were collected for 300 minutes for the measurement of plasma glucose, insulin, C-peptide, lactate and GIP. β-cell function parameters were derived from mathematical modelling of plasma glucose, insulin and C-peptide concentrations. Body composition, fat mass and fat-free mass were evaluated before and 1 and 12 months after RYBP by means of DEXA.
RESULTS:
The average percentage of weight loss after surgery in the 104 patients was 26,5±1,46% and it was maintained at 24 and 36 months follow-up. Diabetes remission at 3 years follow-up occurred in 56,5% of study participants (in 50,0% of LAGB, 56% of RYBP and 100% of SG).
Duration of diabetes was the only significant predictor of diabetes remission at 2 and 3 years.
The 5 patients who underwent MMT (according to ClinicalTrials.gov protocol NCT 01767441), showed, 1 month after RYBP, a significant weight loss: ΔBMI=- 4,07±0,26 kg/m2 p<0,001, Δtotal mass= -10,62±0,61 kg, Δtotal-fat= -5,58±0,74 kg p<0,007. HOMA-IR and plasma insulin decreased (HOMA-IR 17,2±4,8 vs 2.7±0.61 p=0,04; plasma insulin 231,36±21,17 vs 64,92±4,41 pmol/L, p=0,02) as well as insulin AUC and lactate AUC (respectively 66,43±10,5 vs 28,67±5,51 nmol/l in 4 hour; p=0,039 and 258,03±34,76 vs 183,77±32,89 mmol/l in 4 hour; p=0,02). Insulin secretion rate significantly improved (p<0,04).
CONCLUSIONS
Bariatric Surgery appears to be a viable option for the treatment of severe obesity, resulting in long term weight loss and frequent diabetes remission.
Our preliminary data suggest that amelioration in glucose homeostasis, evaluated by a physiological stimulus (MMT), could be related to improvement in β-cell function and insulin sensitivity
Effects of selective H.E.L.P. LDL-apheresis on plasma cytokine concentrations in severe dyslipidemia: implication for anti-inflammatory response
No full textTherapeutic plasmapheresis is a recognized medical procedure in which various techniques are used to separate and remove undesirable or excessively elevated plasma elements from blood. The main purpose of the procedure is toremove the substances responsible for the disease (autoantibodies, circulatingimmune complexes, lipoproteins and other molecules) from the patient`s blood. Low-Density-Lipoproteins-apheresis (LDL_a) is the selective removal of allapolipoprotein-B100-containing lipoproteins: LDL, very low-density lipoprotein, andlipoprotein (a). They are lowered acutely by 65% to 75%. There is little effect onother plasma lipidic and non lipidic components. LDL_a was reported to increaseresistance of LDL to oxidation, counteract procoagulatory state and relief disturbances of hemorheology associated with atherosclerosis. These effects arelikely to be regarded as to be pleiotropic effects. In the sense that they are notnecessarily related to the apolipoprotein-B100-containing lipoproteins level inplasma. There is robust evidence that LDL_a can induce the stabilization ofatherosclerotic plaques through its lipid-lowering action. However, other effectsunrelated to the apolipoprotein-B100-containing lipoproteins extracorporeal removal,such as the decrease of cytokines and adhesion molecules induced by LDL_a werealso reported. Altogether these actions are thought to favorably influence regressionof florid, nonfibrous atherosclerotic lesions through a blockade of lipid deposition inthe vessel wall, plaque stabilization, and ultimately, coronary and extracoronaryartery disease progression. This brief review provides some indication on existing evidence of Heparin-induced Extracorporeal Low-density-lipoprotein Precipitation LDL_a effects on plasma mediators of inflammation
Seismic passive/active thrust on retaining wall-point of application, discussion
No full textdiscussio
Effetti della rugosità superficiale sulla forza di scollamento di elementi di rinforzo in FRP su strutture in calcestruzzo
No full textWhen dealing with the reinforcement of concrete structures by using FRPs it must be taken into account that bonding represents a very important problem. Bonding depends on mechanical and physical properties of concrete, composite and adhesive. Another factor associated with bonding is surface treatment of the concrete.
In this paper, the use of a linear and of a 2D rugosimeter is suggested to analyse and characterize the influence of the surface treatment on the experimental results of pull-off tests in terms of debonding force and fracture energy. In all the specimens, concrete surface were sandblasted before applying the CFRP reinforcement. This procedure is suitable for investigating the fracture surface and fracture modes after the collapse of the specimens
Lipoprotein apheresis and pcsk9-inhibitors. Impact on atherogenic lipoproteins and anti-inflammatory mediators in familial hypercholesterolaemia
No full textBackground: A combination therapy with PCSK9-inhibitors (PCSK9-I) and lipoprotein-apheresis (LA) may have synergistic effects on circulating lipid and lipoprotein levels, in particular in Homozygous Familial Hypercholesterolaemic (HoFH) subjects. The relationships between the above mentioned novel therapeutic approaches as highly effective treatment option for Dyslipidemia in Heterozygous Familial Hypercholesterolaemic (HeFH) patients deserve further investigation in larger datasets. Objective: This review aims to present the role of lipoprotein apheresis in the management of familial hypercholesterolaemia and discuss the potential advantages and disadvantages of its combination with PCSK9 inhibitors. Methods: A comprehensive literature search regarding lipoprotein apheresis in patients with familial hypercholesterolaemia and its combination with PCSK9 inhibitors has been performed. Results: LA is also a potent therapeutic player having impact on inflammation and related mediators. A large body of evidence on this is available. On the contrary, only few observations are available on PCSK9-I effects on inflammation. Conclusions: It is quite clear that further investigation on possible direct and/or indirect pleiotropic effects of PCSK9-I on inflammatory molecules is necessary and to be expected. Evidence on both arguments with regard to HoFH and HeFH, are reported in short
Effects of selective H.E.L.P. LDL-apheresis on plasma inflammatory markers concentration in severe dyslipidemia: Implication for anti-inflammatory response.
No full textTherapeutic plasmapheresis is a recognized medical procedure in which various techniques are used to separate and remove undesirable or excessively elevated plasma elements from blood. The main purpose of the procedure is to remove the substances responsible for the disease (autoantibodies, circulating immune complexes, lipoproteins and other molecules) from the patient’s blood. Low-Density-Lipoproteins- apheresis (LDL_a) is the selective removal of all apolipoprotein-B100-containing lipoproteins: LDL, very low-density lipoprotein, and lipoprotein (a). They are lowered acutely by 65–75%. There is little effect on other plasma lipidic and non-lipidic components. LDL_a was reported to increase resistance of LDL to oxidation, counteract procoagulatory state and relief disturbances of hemorheology associated with atherosclerosis. These effects are likely to be regarded as to be pleiotropic effects. In the sense that they are not necessarily related to the apolipoprotein-B100-containing lipoproteins level in plasma. There is robust evidence that LDL_a can induce the stabilization of atherosclerotic plaques through its lipidlowering action. However, other effects unrelated to the apolipoprotein-B100-containing lipoproteins extracorporeal removal, such as the decrease of cytokines and adhesion molecules induced by LDL_a were also reported. Altogether these actions are thought to favorably influence regression of florid, nonfibrous atherosclerotic lesions through a blockade of lipid deposition in the vessel wall, plaque stabilization, and ultimately, coronary and extracoronary artery disease progression. This brief review provides some indication on existing evidence of Heparin-induced Extracorporeal Low-density-lipoprotein Precipitation LDL_a effects on plasma mediators of inflammation
Gianluigi Zenti, President, Academia Barilla SpA - The Changing Consumer: Demanding but Predictable
Get PDFIt is crucial to understand and predict consumers' behaviour to meet future consumer demands. This report contributes to the discussion by giving an insight into consumers' behaviour from the perspective of Gianluigi Zenti, executive director of Academia Barilla. It is discussed how consumers' choice has changed in
particular with regard to Italian food in the US and how Barilla has responded to that challenge
- …
