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Biomedical subjects

A Andreoli

Publications and source records attributed to A Andreoli.

At least 19 recordsLinked to original sources

[Dissociative disorders: clinical, neurobiological and therapeutical approaches].

Dissociation is a dysfunction of normally integrated functions like memory, consciousness and perception of environment. This review discusses the clinical and etiological issues of dissociative disorder and highlights the importance of differential diagnosis and psychiatric comorbidities, with special attention for the development of reliable evaluation instruments and treatment guidelines. New approaches of dissociative disorder focus on the importance of the integration of anatomical and functional neuroimaging data, combined with endocrinological and biological studies (lipids), in order to develop some specific neurobiological models. Beyond the inherent singularity of psychotherapeutic intervention, the therapeutic approach varies according to frequently associated comorbidities.

Diagnosis, Differential↗

[Quick detection of depression: a significant clinical issue].

Detection of depression is a major issue for public health. In a study performed in the HUG, we tested the concordance of the self-report Patient Health Questionnaire (PHQ-9) with the Hamilton depression scale (HDRS) administered by a psychiatrist, as measures of the severity of depression. The comparison shows that the PHQ-9 distinguishes subjects with and without depressive disorders and is a good screener for severe disorders but has a poor capacity of discrimination when disorders are mild. This instrument is insufficient if the aim is to detect mild or moderate depressive disorders, wich is the most frequent occurrence in patients consulting primary care physicians.

Depression↗

Multicompartment model to assess body composition in professional water polo players.

AIM: The aim of this study was to compare differences between skinfold thicknesses (SK), bioelectrical impedance analysis (BIA), a 2-compartment model (2C), and 2, 3-compartment models (3C) of percent body fat (%BF) assessment with a 4-compartment model (4C) in professional water polo athletes. METHODS: Ten male subjects, 18 to 29 years of age, participated in this study. Under water weighing, deuterium dilution, and dual-energy X-ray absorptiometry (DXA) were used to provide the required values for the models. The two, 3C models used were established by Withers et al. (3C-W) and by the DXA manufacturers (3C-DXA). 4C was also established by Withers et al. RESULTS: There were no significant differences between 2C, 3C-W, and 3C-DXA when compared with 4C (criterion model). There were no significant differences between 2C and 3C-W. %BF was significantly greater using 2C compared with 3C-DXA. %BF derived from SK and BIA were significantly greater than all other METHODS: 4C was best correlated with 3C-W (R2=0.998), followed by 2C (R2=0.806), 3C-DXA (R2=0.5071), SK (R2=0.2945), and BIA (R2=0.2377). CONCLUSION: We conclude that 2C and 3C-W assess %BF equally as well as 4C; however, SK and BIA significantly over-estimated %BF in water polo athletes.

Absorptiometry, Photon↗

Effect of different sports on body cell mass in highly trained athletes.

The objective of this study was to verify the impact of various sports on body cell mass (BCM). Ninety-eight male subjects, 17-33 years of age, participated in the study. The sample included athletes from three professional Italian football (soccer) teams, representing three different divisions (A, n=16; B, n=14; and C, n=18), judo athletes (J, n=10), and water polo athletes (W, n=14) who all competed at the national level. Twenty-six age-matched individuals served as the control group (CG). Fat-free mass (FFM), fat mass (FM), percent body fat (%BF), and BCM were assessed using bioimpedance spectroscopy (BIS). There were no significant differences in body weight and FFM among the groups. A and B were significantly taller than J and CG. B had a significantly lower body mass index (BMI; kg/m(2)) than CG, while C had a significantly lower BMI than J and CG. CG had a significantly greater FM and %BF than A, B, and C. C had a significantly lower BCM than Aand B. CG had a significantly lower BCM than A, B, J, and W. In conclusion, differences in BCM exist among athletes of different sports, and among athletes within the same sport who compete at different levels.

Adipose Tissue↗

Body composition in coeliac disease adolescents on a gluten-free diet: a longitudinal study.

Our aim was to evaluate body composition in a group of coeliac disease adolescents on a gluten-free diet and to re-examine them at the end of the adolescence spurt. We studied 48 patients (group 1A), 30 age-matched healthy controls (group 2A), 11 group 1A patients after 4 years (group 1B) and 11 adolescents who were age- and sex-matched with group 1B (group 2B). Weight, height, bone mineral content, fat mass, fat-free mass (FFM) and bone mineral density were evaluated using dual-energy X-ray absorptiometry. All parameters were lower in group 1A than in group 2A subjects ( p<0.001). After 4 years, the body compartments of group 1B coeliac disease patients normalised, except for weight and FFM which remained lower than in group 2B subjects ( p<0.005). In conclusion, our study demonstrates that adolescence is a period where some parameters of body composition can still be recovered.

Absorptiometry, Photon↗

Body composition differences in adolescent female athletes and anorexic patients.

Osteopenia is a frequent complication affecting adolescent girls with anorexia nervosa (AN). Moreover, female athletes suffering from eating disorders can be affected by premature osteoporotic fractures. The aim of this study was to examine bone mineral content (BMC) and bone mineral density (BMD) in three groups of adolescent females. Anthropometric and body composition measurements were performed on 22 adolescent females (age+/-SD=15.6+/-1.4 years) divided into groups: athletes ( n=8), patients with AN ( n=8) and age-height matched control subjects ( n=6). Body weight and body mass index were significantly lower ( p<0.01) in athletes and AN patients compared with healthy controls. BMC and BMD were lower ( p<0.01) for AN patients and athletes compared with healthy controls; AN patients had the lowest BMC value. Athletes had higher lean body mass values compared with AN patients and healthy controls. These results suggest that the effects of eating disorders, specifically BMC loss, could be attenuated by physical activity.

Adipose Tissue↗

Use of foot-to-foot bioelectrical impedance analysis in children.

The aim of this study was to compare two methods of measuring body composition in children aged 6-10 years: with a traditional bioelectrical impedance analyser and a foot-to-foot impedance device. In 117 subjects (55 girls, 62 boys), bioelectrical impedance was measured using a Xitron 4000 device and a foot-to-foot impedance instrument (Rowenta); body fat mass and fat-free mass were then calculated and comparisons between means were performed using appropriate statistical tests.

Body Composition↗

Predicting fat-free mass in children using bioimpedance analysis.

Body composition assessment is a useful procedure for the study of nutritional status and water distribution. In adults, it is a predictor of morbidity and mortality, since body fatness is associated with risk factors for cardiovascular disease. Bioelectric impedance analysis (BIA) is a simple, safe, and inexpensive method for assessment of body composition both in pediatric and adult subjects. The aim of our study was to validate the impedance index, ZI (H(2)/Z, height in cm(2)/impedance), as a predictor factor of fatfree mass (FFM) and fat mass (FM) in a sample ( n=75) of normal children. Dual-energy X-ray absorptiometry (DXA) was chosen as reference method. Despite some minor bias, DXAis considerably less expensive and easier to administer in pediatric subjects than other established gold standard reference methods for assessing body composition. ZI values were highly correlated with FFM measured with DXA. The following equations were obtained from the regression analysis: (a). male subjects, FFM(DXA)=0.6375 (ZI)+5.9913, r(2)=0.897, p<0.0001; (b). female subjects, FFM(DXA)=0.7597 (ZI)+ 3.5853, r(2)=0.903, p<0.0001. These data support the notion that BIA alone can be used as a surrogate to measure FFM in a pediatric sample.

Absorptiometry, Photon↗

Maternal cardiac systolic function and total body water estimation in normal and gestational hypertensive women.

We assessed total body water (TBW) content and cardiac function in 25 normotensive (N) and 22 gestational hypertensive (GH) women matched for age, gestational age, and prepregnancy body mass index (BMI) during the third trimester of gestation. Patients underwent maternal echocardiography, bioelectrical impedance analysis (BIA), and hematocrit (Hct %) evaluation. The TBW:Hct ratio (water balance index, WBI) was calculated. Hct was significantly lower in N vs. GH women (31.9+/-2.2% vs. 36.2+/-2.5; p<0.001). There was no difference in TBW between the two groups. WBI was higher in N vs. GH women (1.35+/-0.20 l.kg(-1) x m(-2) vs. 1.19+/-0.18; p<0.001). N subjects showed a higher stroke volume than GH patients (78.0+/-9.7 ml vs. 67.9+/-10.2; p=0.001). Atrial function was higher in N vs. GH women (left atrial fractional area change 57.4+/-5.1% vs. 42.5+/-7.5; p<0.001). A correlation was found between stroke volume and WBI ( r=0.93, p<0.0001). Maternal cardiac function and WBI are strongly related and might help in understanding the mechanisms of adaptation in normal and hypertensive pregnancy.

Adult↗

How fat is obese?

The aim of the study was a comparison between body fat measurements and body mass index. We analyzed the data of 890 subjects, 596 females and 294 males, ranging in age from 18 to 83 years, in body mass index (BMI) from 14 to 54 kg/m(2), and in body fat percentage (BF%) from 4% to 57%. A considerable number of subjects, both males and females, could not be classified as obese based on their BMI alone. Such a misclassification is undesirable, especially in general practice, and it calls for diagnostic criteria other than the BMI alone to be used for obesity.

Adipose Tissue↗

Body composition modification in obese patients treated with intragastric balloon.

At the Centre for the Therapy of Morbid Obesity, a multidisciplinary team attends severely obese patients in a day-care hospital setting. The patients' psychological and nutritional profiles are studied and their body composition investigated with bioelectrical impedance. After the diagnosis, several approaches are proposed; among them, the insertion of a Bioenterics Intragastric Balloon (BIB). For 6 months after insertion, patients were periodically examined and followed a strict personal regimen, behaviour schedule and physical activity programme compatible with the BIB. The results obtained from the first 20 subjects are encouraging. No severe complications have been reported, and after the BIB removal, subjects are maintaining the obtained results with some of them continuing to lose weight.

Adolescent↗

Review article: breath testing for human liver function assessment.

Carbon-labelled breath tests were proposed as tools for the evaluation of human liver function 30 years ago, but have never become part of clinical routine. One reason for this is the complex role of the liver in metabolic regulation, making it difficult to provide essential information for the management of patients with liver disease with a single test and to satisfy the hepatology community. As a result, a battery of breath tests have been developed. Depending on the test compound administered, different metabolic pathways (microsomal, cytosolic, mitochondrial) can be examined. Most available data come from microsomal function tests, whilst information about cytosolic and mitochondrial liver function is more limited. However, breath tests have shown promise in some studies, in particular to predict the outcome of patients with chronic liver disease or to monitor hepatic function after treatment. Whilst we await new substrates that can be used to measure liver function in a more valid manner, and large prospective studies to assess the usefulness of available test compounds, the aim of this review is to describe how far we have come in this controversial and unresolved issue.

Breath Tests↗

Ineffectiveness of probiotics in preventing recurrence after curative resection for Crohn's disease: a randomised controlled trial with Lactobacillus GG.

BACKGROUND AND AIMS: Experimental studies have shown that luminal bacteria may be involved in Crohn's disease. Probiotics are a possible alternative to antibiotics. The aim of this randomised placebo controlled study was to determine if Lactobacillus GG, given by mouth for one year, could prevent Crohn's recurrent lesions after surgery or to reduce their severity. METHODS: Patients operated on for Crohn's disease in whom all of the diseased gut had been removed were randomly allocated to receive 12 billion colony forming units of Lactobacillus or identical placebo for one year. Ileocolonoscopy was performed at the end of the trial or at the onset of symptoms. Endoscopic recurrence was defined as grade 2 or higher of Rutgeerts scoring system. RESULTS: Eight of 45 patients were excluded from the trial (three for non-compliance and five for protocol violations). Clinical recurrence was ascertained in three (16.6%) patients who received Lactobacillus and in two (10.5%) who received placebo. Nine of 15 patients in clinical remission on Lactobacillus (60%) had endoscopic recurrence compared with six of 17 (35.3%) on placebo (p=0.297). There were no significant differences in the severity of the lesions between the two groups. CONCLUSIONS: Lactobacillus GG seems neither to prevent endoscopic recurrence at one year nor reduce the severity of recurrent lesions.

Adult↗

Effect of subclinical hypothyroidism and obesity on whole-body and regional bone mineral content.

OBJECTIVE: The present investigation was aimed to evaluate the effect of subclinical hypothyroidism and obesity on bone mineral content (BMC) in different body segments. METHODS: Thirty-two premenopausal women (age: 37 +/- 9.9 years), with a wide range in body mass index (BMI), were studied. Subclinical hypothyroidism was defined by a basal TSH > or = 4 microU/l and/or a TRH-stimulated peak > or = 30 microU/l. For each subject, weight, height, BMI (weight/height(2)) and the waist/hip ratio were measured. Total BMC, total bone mineral density (BMD), leg BMC, leg BMD, trunk BMC, trunk BMD, arm BMC and arm BMD were determined using dual-energy X-ray absorptiometry. Thyroid function (basal and TRH-stimulated TSH, free T(3) and free T(4)) were determined from fasting blood samples for all subjects. RESULTS: Anova was conducted within all the groups to observe the effect of thyroid status and/or obesity on BMC and BMD. There was no statistical difference for age. Total BMC was affected by obesity (p < 0.05) but not by thyroid status, BMD of the legs was significantly influenced both by thyroid function and obesity (p < 0.01); total BMD was affected by hypothyroid status (p < 0.05). A direct relationship between leg BMD and TSH was demonstrated. CONCLUSION: Subclinical thyroid hypofunction and obesity seem to affect BMD differently in the body segments. An influence of gravitational force seems necessary in order to make evident the effect of subclinical hypothyroidism on bone. A condition of subclinical hypothyroidism should be considered when evaluating subjects for osteoporosis, since a BMD measured at the femoral neck may induce underestimation of initial osteoporosis.

Absorptiometry, Photon↗

Bioelectrical impedance measures in different position and vs dual-energy X-ray absorptiometry (DXA).

BACKGROUND: Bioelectrical impedance analysis (BIA) is a safe, low-cost, non-invasive, rapid method for the assessment of body composition. It has therefore a great potential to be employed for epidemiological and clinical studies. However, many devices are available to estimate total body water (TBW), fat-free mass (FFM) and fat mass (FM) by bioelectrical impedance measurements. Moreover, bipedal devices allowing measurements in the only standing position are recently developed. They are easy and practical to use without operator, so a large diffusion can be forecasted in fields as sport and diet programs. Comparison of body composition estimation by a bipedal device with bioimpedance devices currently used, using dual-energy X-ray absorptiometry (DXA) as reference method. METHODS: The study was performed on 18 healthy women volunteers, age 32.0+/-10.7 years divided in two groups at different levels of body fatness. A Xitron 4000 impedance analyser, a BIA-101 RJL System, and the bipedal device Tanita were used for comparison. The measurements were performed in standing and supine position for Xitron and RJL devices. DXA measurements were performed with a total body scanner DPX, Lunar. RESULTS: FM and FFM were not statistically different when measured with Xitron and RJL in comparison with DXA, while these variables were significantly different between Tanita and DXA measurements. No significant difference were found between measurements in the supine and standing position with the Xitron and RJL system. CONCLUSIONS: Our results suggest that FM and FFM evaluated by bipedal device Tanita are significantly different from FM and FFM measured by DXA in both normal and obese population.

Absorptiometry, Photon↗

Prediction of lean body mass from multifrequency segmental impedance: influence of adiposity.

The aim of the study was to determine the influence of adiposity on the relationship between bioelectrical impedance (BIA) measurements of body segments and estimation of body composition by dual-energy X-ray absorptiometry (DXA). Multiple frequencies of whole body and segmental impedances were measured in 68 normal-weight and obese subjects (46 women and 22 men), mean age 37.2+/-14.8 years (range, 18-69). Total and appendicular lean body mass (LBM) assessed by DXA correlated significantly with total and segmental impedance values adjusted for stature in both obese and normal-weight subjects. Best fitting equations for the prediction of appendicular LBM from segmental impedance measurements were derived for the arm and leg with and without the inclusion of adiposity (the percentage of body fat measured by DXA) in the regression models. Best prediction was obtained at low frequency for the arm and high frequency for the leg. Adiposity appears to significantly influence the prediction of leg LBM by BIA. These preliminary observations need further validation to provide an accurate assessment of appendicular LBM assessment by BIA.

Absorptiometry, Photon↗

Measured and predicted resting metabolic rate in Italian males and females, aged 18-59 y.

OBJECTIVES: To determine the resting metabolic rate in a sample of the Italian population, and to evaluate the validity of predictive equations for resting metabolic rate (RMR) from the literature in normal and obese subjects. DESIGN: Cross-sectional observational study. SETTINGS: Department of Human Physiology and Nutrition, University 'Tor Vergata', Rome. SUBJECTS: A total of 320 healthy subjects, 127 males and 193 females, aged 18-59 y. METHODS: Weight, height and resting metabolic rate by indirect calorimetry were measured. Resting metabolic rate was also predicted using equations from the literature. RESULTS: Resting metabolic rate (mean s.d.) in normal weight subjects was 7983+/-1007 kJ/24 h (males) and 6127 907 kJ/24h (females). Measured RMR and predicted RMR values using various equations from the literature were significantly different in males and females, except for the Harris-Benedict equation and the Schofield equations. Also, in overweight and obese subjects the prediction error was generally larger compared to normal-weight subjects for all formulas except for the Harris-Benedict and Schofield formulas. In overweight and obese males but not in females, RMR was lower than in normal-weight subjects after correcting for weight and age differences. Stepwise multiple regression of resting metabolic rate against weight, height and age in males and females did not reveal a prediction formula with a lower prediction error than the Harris-Benedict or Schofield formulas and thus was not further explored. CONCLUSIONS: The Harris-Benedict formula and the Schofield formula provide a valid estimation of resting metabolic rate at a group level in both normal-weight and overweight Italians. However, the individual error can be so high that for individual use a measured value has to be preferred over an estimated value.

Adolescent↗

The validity of predicted body fat percentage from body mass index and from impedance in samples of five European populations.

OBJECTIVES: To test and compare the validity of a body mass index (BMI)-based prediction equation and an impedance-based prediction equation for body fat percentage among various European population groups. DESIGN: Cross-sectional observational study. SETTINGS: The study was performed in five different European centres: Maastricht and Wageningen (The Netherlands), Milan and Rome (Italy) and Tampere (Finland), where body composition studies are routinely performed. SUBJECTS: A total of 234 females and 182 males, aged 18-70 y, BMI 17.0-41.9 kg/m(2). METHODS: The reference method for body fat percentage (BF%(REF)) was either dual-energy X-ray absorptiometry (DXA) or densitometry (underwater weighing). Body fat percentage (BF%) was also predicted from BMI, age and sex (BF%(BMI)) or with a hand-held impedance analyser that uses in addition to arm impedance weight, height, age and sex as predictors (BF%(IMP)). RESULTS: The overall mean (+/-s.e.) bias (measured minus predicted) for BF%(BMI) was 0.2+/-0.3 (NS) and-0.7+/-0.3 (NS) in females and males, respectively. The bias of BF%(IMP) was 0.2+/-0.2 (NS) and 1.0+/-0.4 (P<0.01) for females and males, respectively. There were significant differences in biases among the centres. The biases were correlated with level of BF% and with age. After correction for differences in age and BF% between the centres the bias of BF%(BMI) was not significantly different from zero in each centre and was not different among the centres anymore. The bias of BF%(IMP) decreased after correction and was significant from zero and significant from the other centres only in males from Tampere. Generally, individual biases can be high, leading to a considerable misclassification of obesity. The individual misclassification was generally higher with the BMI-based prediction. CONCLUSIONS: The prediction formulas give generally good estimates of BF% on a group level in the five population samples, except for the males from Tampere. More comparative studies should be conducted to get better insight in the generalisation of prediction methods and formulas. Individual results and classifications have to be interpreted with caution.

Absorptiometry, Photon↗