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Biomedical subjects

R Borrelli

Publications and source records attributed to R Borrelli.

16 recordsLinked to original sources

Resting blood pressure and cardiovascular response to sympathetic stimulation in adolescents.

The prevalence of significant hypertension in childhood may be higher than expected. We have measured sitting blood pressure in 168 11-yr-old children attending a pre-high school in the Neapolitan area on four occasions over a 3-month period. We have also measured blood pressure and heart rate during a mental arithmetic test and during isometric exercise. Prevalence of significant hypertension (diastolic blood pressure 82-90 mmHg) was 13% at the first visit and decreased to 6.5% at the last visit; prevalence of severe hypertension (diastolic blood pressure greater than or equal to 90 mmHg) decreased from 5.4% to 1.2% from the 1st to the 4th visit. No sex-related difference was observed. A more frequently positive family history of hypertension (50% vs 30% in the fifth and first quintile of blood pressure, respectively) and higher body weight (body mass index = 21.4 vs 19.3 kg/m2) were found in children in the 5th quintile of blood pressure distribution. Blood pressure increased during mental arithmetic by 10/13% of the resting values in the first quintile and by 6/11% in the last one during mental test; during handgrip the increase was of 20/37% and 24/46%, respectively: differences between quintiles did not reach statistical significance. These data show that about 8% of a Neapolitan sample of school population have high blood pressure levels, while no difference in vascular reactivity to sympathetic stimulation was detected in children with higher blood pressure.

Age Factors

Inter- and intra-individual variability in food intake of elderly people in Perugia (Italy).

It has been shown that each individual has a considerable day-to-day variation (intra-individual variation) in his or her level of food consumption. A large intra-individual variation has adverse effects on the reliability of research studies. The effect of the intra-individual variation can be minimized by taking food intake records over several days. An increase in the number of days entails higher costs, and this could limit the practicability of the study. In the recent literature on the methodology of dietary surveys, there is a growing interest in the estimation of the number of days required to conduct a reliable dietary survey. Recent developments in statistical theory allow the problem of large intra-individual variability to be overcome. These new statistical techniques require knowledge of the intra- and inter-individual variability and the appropriate adjustment of the statistical results. The aim of the present study was to evaluate the number of days of recorded intake required to obtain an estimate of the components of variance (the inter-individual and the intra-individual variability) focusing on foods rather than nutrients.

Aged

Postprandial thermogenesis in leanness and anorexia nervosa.

Resting energy expenditure (REE) and postprandial thermogenesis (PPT) after the ingestion of a mixed test meal (3.56 MJ, 850 kcal) were determined in 7 anorectic patients, 7 very lean women and 8 control women. REE is absolute value was sharply decreased in the anorectics, but did not significantly differ between the very lean and the control subjects. On the other hand, when adjusted for body weight, REE only tended (p = 0.18) to be lower in the anorectics in comparison to the control women. PPT was similar in the anorectics (187.2 +/- 24.6 kJ/4 h) and the controls (200.7 +/- 16.8 kJ/4 h), but lower in the lean subjects (137.5 +/- 20.0 kJ/4h: p less than 0.05) than in the other two groups. The present study shows that the thermic response to the ingestion of a mixed test meal was not decreased in undernourished anorectic patients whereas it was significantly reduced in very lean healthy women.

Adult

Cardiovascular response to mental stress and to handgrip in children. The role of physical activity.

Cardiovascular responses to sympathetic stimulation may be altered in the early phases of life of subjects with a family history of hypertension. The possible influence of physical activity on adrenergic modulation in children is still not well known. In this study we evaluated, in a group of 162 11-year-old children from a secondary school near Naples, blood pressure and heart rate measured 4 times at 3-week intervals at rest and during adrenergic system stimulation by mental arithmetic stress and isometric exercise. Children were divided into sedentary and physically active groups according to the levels of a Saltin modified questionnaire. Family history of hypertension was also investigated. Systolic and diastolic blood pressure at rest were slightly higher in the sedentary group at each control (107/75 +/- 11/11 vs 105/73 +/- 11/11 mmHg at the first and 100/70 +/- 14/14 vs 98/69 +/- 9/9 at the last control); heart rate in the same group was higher as well (91 +/- 11 vs 87 +/- 12 beats/min, p less than 0.02 at the first and 80 +/- 9 vs 77 +/- 11 at the last control). Systolic and diastolic blood pressure increased by 7/15% during mental stress and by 23/45% during isometric exercise in the sedentary group. The corresponding blood pressure increases in the physically active group were 6/12% and 20/40%, respectively. These responses were independent of sex, body weight and family history of hypertension. These results support the hypothesis that regular physical activity in young adolescents only mildly influences resting blood pressure and cardiovascular responses during the stimulation of the sympathetic nervous system.

Blood Pressure

Evaluation of new computerized method for recording 7-day food intake in IDDM patients.

OBJECTIVE: To evaluate a new computerized method for recording 7-day food intake. RESEARCH DESIGN AND METHODS: Randomized crossover trial was conducted with patients recording the amount and type of every food and drink consumed during a week by either a computerized device (Food-meter) or recording the data in a diary. Each method was applied twice. Twenty-one insulin-dependent diabetic patients (mean +/- SD age 25 +/- 9 yr) were studied. RESULTS: The two methods showed very good agreement in the evaluation of the patients' diets (1792 +/- 408 vs. 1764 +/- 436 kcal/day, 84 +/- 19 vs. 82 +/- 21 g/day protein, 68 +/- 22 vs. 67 +/- 23 g/day fat, 210 +/- 60 vs. 207 +/- 58 g/day carbohydrate with the conventional and computerized methods, respectively). The variability between the methods and the variability within each method were of similar magnitude. CONCLUSIONS: The Food-meter represents a useful tool for computerizing the 7-day food record. The method is easy, reliable, and time saving. Moreover, it minimizes the risk of transcriptional errors.

Adult

Collection of food intake data: a reappraisal of criteria for judging the methods.

The relationship between diet and the development of chronic disease still remains a controversial area. One major difficulty is to obtain a valid estimate of habitual pattern and level of food consumption for each individual. There is, in fact, a voluminous and largely negative literature on the validity of dietary assessment methods. In the present paper the utility of the most frequently used dietary assessment method in epidemiological studies is discussed in terms of precision and accuracy.

Bias

Albumin and labile-protein serum concentrations during very-low-calorie diets with different compositions.

Circulating concentrations of albumin and the labile proteins prealbumin (PA) and retinol-binding protein (RBP) were evaluated over 20 d in five groups of obese patients. The patients were given four types of very-low-calorie diets (VLCDs) (less than 500 kcal/d) that provided different amounts of protein or carbohydrate (CHO) plus protein and a conventional 1200-kcal/d hypocaloric diet. Serum albumin concentrations did not vary significantly during any of the diets whereas PA and RBP remained unchanged only during the conventional 1200-kcal/d diet. Similar and significant decreases of serum PA and RBP were observed during the VLCDs studied. The molar ratio of RBP to PA did not vary during dieting. Thus, when less than 500 kcal/d are given, changes of serum short-half-life visceral proteins are not affected by either the addition of CHO to protein or the changes in protein intake. Moreover, serum albumin concentration and RBP/PA do not vary during VLCDs.

Adult

Body weight and cardiovascular response to sympathetic stimulation in childhood.

The possible relationship between cardiovascular response to adrenergic stimulation and body weight has been studied in 166 eleven-year-old students (103 male, 63 female). Resting blood pressure (BP) by random-zero machine, heart rate (HR) and body weight (BMI) were measured four times in the school at 3-week intervals. On the third visit a mental arithmetic stress was carried out and a 24 h urine specimen was collected for the measurements of catecholamine excretion. On the fourth visit students carried out an isometric exercise (handgrip). Girls were more frequently found in the last quintiles of BMI (10/33 in the first vs 19/33 in the fifth). This might be due to a more advanced sexual maturation. BP at rest significantly increased with body weight (from 105/81 +/- 11/13 mmHg in the first to 119/87 +/- 10/12 in the fifth quintile). In each quintile no sex-related difference was observed in BP or HR. A marked cardiovascular response was observed during both tests without significant difference among quintiles. The 24 h urinary excretion of total catecholamines slightly increased with body weight (from 26.2 +/- 11 micrograms/24 h in the first to 34.5 +/- 19.5 micrograms/24 h in the fifth quintile). These data in a population of 11-year-old students therefore support the hypothesis that although BP at rest is influenced by BMI, the cardiovascular response to adrenergic stimulation is independent of body weight.

Blood Pressure

Some statistical considerations on dietary assessment methods.

Dietary intake for 18 nutrients in a sample of 230 free-living elderly people in Naples was assessed by three dietary assessment methods (diet history, 24-h recall and 3-d record). Different statistical criteria (the correlation coefficient, the mean difference and the proportion of individuals placed in the same thirds of distribution) were used to evaluate the agreement among different methods. Theoretical considerations are shown demonstrating the uselessness of the correlation coefficient in evaluating the agreement. In analysing the mean differences, diet history gave higher estimates of nutrient intake and 24-h recall gave lower estimates, when compared to the 3-d record. Large standard errors for the mean differences and small proportions of individuals placed in the same thirds of the distribution, for nearly all the nutrients examined, showed poor agreement among the three different methods. These findings strongly suggest the presence of bias in, at least, two of the three dietary assessment methods. Some statistical techniques for improving the diet record method in epidemiological studies are discussed: the need to transform nutrient intake data to achieve normality in the distribution; the number of days of recording required to produce a valid study; and the need to evaluate the bias in the diet record.

Aged

Cardiovascular risk factors and age of onset of obesity in severely obese patients.

Aim of this study was to evaluate whether the age of onset of obesity might affect the prevalence of CV risk factors in severely obese patients. Five hundred forty-five (385 F aged 42.3 +/- 7.1 yrs, BMI 47.3 +/- 5.1 w/h2 and 160 M of 39.0 +/- 1.1 yrs and BMI of 41.8 +/- 5.3 w/h2) severely obese patients hospitalized in the Metabolic Unit between 1972 and 1985 were subdivided in four classes according to the age of onset of obesity. Severely obese women with maturity onset obesity (i.e. onset greater than or equal to 20 yrs) (MOO) had higher (p less than or equal to .01) serum glucose (118 vs 103 mg/dl) and triglyceride (167 vs 126 mg/dl) than those with early onset obesity (EOO) (i.e. onset less than or equal to 3 yrs) with the same age, BMI and smoking habits. Similar trend was also found in men. In males arterial blood pressure was found to be higher (p less than or equal to .01) in EOO than in MOO (SBP = 152 vs 133 mmHg and DBP = 92 vs 83 mmHg). Similar trend was found in females. In conclusion age of onset of obesity may, at least in part, affect the prevalence of cardiovascular risk factors in severe obesity.

Adult

Mortality rate, causes and predictive factors of death in severely obese patients.

Several studies have investigated the relationship between obesity and mortality or cardiovascular disease (CVD) reporting conflicting results. The very few data collected on extremely obese patients have shown an increased mortality in these patients compared to the general population. Two hundred and sixtyfour (182 f, 82 m) severely obese patients (BMI greater than or equal to 35 w/h2) living in Southern Italy (hospitalized from 1972 to 1985 in our Metabolic Unit for a weight reduction program) were followed-up for a mean period of 7.1 years. Twentynine (20f, 9m) deaths were recorded during the follow-up. Higher mortality was found at all ages and in both sexes in these patients when compared to the general italian population. The excess mortality reached its peak in the age range 25-54 yrs (observed/expected mortality rate was 6.9 in females and 4.32 in males) diminishing by aging in both sexes (3.52 in females and 1.56 in males in age range 55-72 yrs). Death from CV disease was found more frequent than in the general italian population but it was unable to fully explain the excess mortality. Predictive factors of mortality were: in females age, BMI, and serum glucose and in males only age. In conclusion severely obese patients living in Southern Italy have a very high mortality rate. The excess mortality is not fully explained by cardiovascular disease.

Actuarial Analysis

Protein balance during very-low-calorie diets for the treatment of severe obesity.

Very-low-calorie diets (less than 500 kcal/day; VLCD) are widely used for the treatment of severe obesity. We report the effects of such diets, consisting of proteins only or proteins and carbohydrates (CH), on nitrogen balance and protein nutritional status of morbidly obese patients. Cumulative nitrogen loss, serum albumin, transferrin, prealbumin (PA) and retinol-binding protein (RBP) concentrations, and plasma amino acid profile were determined in two groups of obese patients: 5 subjects (3 women, 2 men: BMI 55.3 +/- 2.2 kg/m2) subjected for 4 weeks to a protein VLCD (40 g protein + 2 g fat) and 7 others (4 women, 3 men: BMI 45.6 +/- 2.8 kg/m2) received for the same length of time a protein + CH VLCD (34 g protein + 26 g CH). Nitrogen balance was determined weekly whilst plasma and serum variables were measured on days 0, 3, 5, 10, 20 and 28 of treatment. Nitrogen balance did not significantly differ between the two groups of patients throughout the treatment. Serum PA and RBP concentrations decreased from day 5 and day 10, respectively, in both groups. Plasma amino acids showed a similar pattern in the protein and protein + CH groups. Alanine gradually decreased below baseline values; after a peak value on day 5, branched-chain amino acids (valine, leucine, isoleucine) returned to baseline values in both groups. In conclusion, in severely obese patients subjected to VLCD, nitrogen balance, labile protein concentrations and plasma amino acid profile are not significantly affected by adding CH to proteins.

Adult

[Validity of 5 bioelectric impedance equations for the estimation of lean body mass in women].

Fat free mass (FFM) predicted by five bioelectrical impedance (BIA) available formulae (Segal et al., Lukaski et al., Kushner et al., Deurenberg et al., manufacturer's predictive equation) was compared with densitometrically-determined FFM (as a reference method) in two groups of young women with different anthropometric characteristics. In the farmers (very short and light individuals), none of the studied formulae was able to accurately predict FFM: this latter was overestimated in subjects with low and underestimated in those with high FFM. In the other group (INCAP employees), only values predicted by Lukaski formula were in perfect agreement with FFM, showing no bias depending on FFM changes. In conclusion, the available BIA formulae seem to be specific for population from which they were derived and could not be used on samples from other populations if not cross-validated.

Adolescent

[Statistical techniques for developing equations for impedance measurement].

The use of impedance analysis is becoming increasingly widespread as a safe, non-invasive and quick method to assess body composition. Numerous equations, based on variables derived from anthropometric variables as well as from impedance measurements analysis, have been developed to predict the alipidic mass from the resulting analysis. The most frequently used statistical method is the least squares technique. The inadequate reliability of this statistical technique is examined in this study and the use of the technique known as "ridge regression" is suggested.

Adipose Tissue