A Pilot Study of Infrared Thermography Based Assessment of Local Skin Temperature Response in Overweight and Lean Women during Oral Glucose Tolerance Test.

Obesity is recognized as a major public health issue, as it is linked to the increased risk of severe pathological conditions. The aim of this pilot study is to evaluate the relations between adiposity (and biophysical characteristics) and temperature profiles under thermoneutral conditions in normal and overweight females, investigating the potential role of heat production/dissipation alteration in obesity. We used Infrared Thermography (IRT) to evaluate the thermogenic response to a metabolic stimulus performed with an oral glucose tolerance test (OGTT). Thermographic images of the right hand and of the central abdomen (regions of interests) were obtained basally and during the oral glucose tolerance test (3 h OGTT with the ingestion of 75 g of oral glucose) in normal and overweight females. Regional temperature vs BMI, % of body fat and abdominal skinfold were statistically compared between two groups. The study showed that mean abdominal temperature was significantly greater in lean than overweight participants (34.11 ± 0.70 °C compared with 32.92 ± 1.24 °C, p < 0.05). Mean hand temperature was significantly greater in overweight than lean subjects (31.87 ± 3.06 °C compared with 28.22 ± 3.11 °C, p < 0.05). We observed differences in temperature profiles during OGTT between lean and overweight subjects: The overweight individuals depict a flat response as compared to the physiological rise observed in lean individuals. This observed difference in thermal pattern suggests an energy rate imbalance towards nutrients storage of the overweight subjects.

A wize mirror for lifestyle improvement.

This paper discusses the problem of fostering lifestyle changes towards healthier habits via tailored user guidance. We present a novel multisensory device, the Wize Mirror, which will be able to detect semeiotic face signs related to cardio-metabolic risk, and encourage users to reduce their risk by improving their lifestyle. Offering a proper user guidance requires solving three main issues: user profiling, definition of a wellness index based on biophysical data, and personalized guidance by means of coaching and supportive messages. For each of these issues, the solutions proposed in the EU FP7 Project SEMEOTICONS are presented, highlighting their advantages with respect to the state-of-the-art.

Cardiac function and oxygen saturation during maximal breath-holding in air and during whole-body surface immersion.

INTRODUCTION: The magnitude of the oxygen-sparing effect induced by the diving response in humans is still under debate. We wished to compare cardiovascular changes during maximal breath-holding (BH) in air and during whole-body immersion at the surface in a group of BH divers. METHODS: Twenty-one divers performed a maximal static apnea in air or during whole-body immersion. Dopplerechocardiography, arterial blood pressure and haemoglobin saturation (SaO2) were obtained at the beginning of, and at 1/3, 2/3 and maximal BH time. RESULTS: BH time was on the average 3.6 ± 0.4 min, with no differences between the two conditions. SaO2 significantly decreased during BH in both conditions, but was significantly higher during immersion as compared to the dry (P = 0.04). In both conditions, BH induced a significant linear increase in right ventricular diameter (P < 0.001), left ventricular (LV) volumes (P < 0.001) and LV stroke volume (P < 0.001) but a significant linear decrease in LV ejection fraction (P = 0.033). In both conditions, Doppler diastolic parameters showed changes suggesting a constrictive/restrictive left ventricular filling pattern (i.e., an increase of early diastolic left ventricular filling velocity, P = 0.005, and a decrease in the deceleration time of early diastolic left ventricular filling. P < 0.001). CONCLUSION: BH induces progressive LV enlargement both in air and whole-body immersion, associated with reduced LV ejection fraction and progressive hindrance to diastolic filling. For a similar apnea duration, SaO2 decreased less during immersed BH, indicating an O2-sparing effect of diving, suggesting that interruption of apnea was not triggered by a threshold critical value of blood O2 desaturation.

Post-dive ultrasound detection of gas in the liver of rats and scuba divers.

In a previous study, we obtained histologic documentation of liver gas embolism in the rat model of rapid decompression. The aim of the study was to assess in the same model occurrence and time course of liver embolism using 2-D ultrasound imaging, and to explore by this means putative liver gas embolism in recreational scuba divers. Following 42 min compression at 7 ATA breathing air and 12 min decompression, eight surviving female rats were anesthetized and the liver imaged by ultrasound at 20 min intervals up to 120 min. A significant enhancement of echo signal was recorded from 60 to 120 min as compared to earlier post-decompression times. Enzymatic markers of liver damage (AST, ALT, and GGT) increased significantly at 24 h upon decompression. Twelve healthy experienced divers were studied basally and at 15-min intervals up to 60 min following a 30-min scuba dive at 30 msw depth. At 30 min upon surfacing echo images showed significant signal enhancement that progressed and reached plateau at 45 and 60 min. Total bilirubin at 24 h increased significantly (p = 0.02) with respect to basal values although within the reference range. In conclusion, 2-D ultrasound liver imaging allowed detection of gas embolism in the rat and defined the time course of gas accumulation. Its application to scuba divers revealed liver gas accumulation in all subjects in the absence of clear-cut evidence of liver damage or of any symptom. The clinical significance of our findings remains to be investigated.

Propagação vegetativa de jambeiro vermelho [Syzygium malaccense (L.) Merr. & L.M. Perry] / Vegetative propagation of malay apple [Syzygium malaccense (L.) Merr. & L.M. Perry]

O jambeiro vermelho [Syzygium malaccense (L.) Merr. & L.M. Perry] se apresenta como opção ao fruticultor por apresentar frutos atrativos e bem aceitos pelo consumidor. A dificuldade de cultivo dessa espécie reside no fato de que a planta possui um porte demasiadamente alto e longo período juvenil quando propagada por semente, com isso, é desejável sua multiplicação vegetativa visando a antecipar o período produtivo e diminuir seu porte. Foi estudada a possibilidade de clonagem dessa espécie pelas técnicas de estaquia, alporquia e enxertia. No experimento por estaquia, testaram-se três doses de ácido indolbutírico (AIB) (0, 1.000 3.000 e 5.000 mg L-1) em dois comprimentos de estacas herbáceas (15 e 25 cm). No experimento de alporquia, avaliaram-se duas épocas de realização do alporque (verão e outono) e quatro doses de AIB (0, 1.000, 4.000, 7.000 e 10.000 mg kg-1). Na enxertia, analisou-se a compatibilidade do jambeiro vermelho (S. malaccense) sobre o jambeiro rosa [Syzygium jambos (L.) Alston] com dois diâmetros de porta-enxertos (0,5 e 0,8 cm) em duas épocas (inverno e verão), pelo método de enxertia de topo em fenda cheia. A estaquia obteve até 20 por cento de enraizamento, independentemente da dose de AIB, exceto na dose de 5.000 mg L-1, que apresentou efeito negativo ao enraizamento entre estacas de 15 cm; não houve sucesso para alporquia e enxertia, nas condições estudadas.

The Malay Apple [Syzygium malaccense (L.) Merr. & L.M. Perry] is an option for the producer as its fruits are attractive and well accepted by the consumer. The difficulty of culture of this species is that the plant is very tall and has a long juvenile period when propagated by seed, making its vegetative propagation necessary to anticipate the productive period and decrease its size. The possibility of vegetative propagation of this species was studied by cutting, layering, and grafting. In the cutting experiment, three doses of indolbutyric acid (IBA) (0, 1,000, 3,000, and 5,000 mg L-1) were tested in two lengths of herbaceous cuttings (15 and 25 cm). In the layering experiment, two periods of layering (summer and autumn) and four doses of IBA (0, 1,000, 4,000, 7,000, and 10,000 mg kg-1) were evaluated. For grafting, the compatibility between S. malaccense and S. jambos (L.) Alston as rootstock was studied with two diameters (0.5 and 0.8 cm) and in two periods (winter and summer), by method of full graft. For cuttings, the percentage of rooting was 20 percent, independently of the IBA doses, except for 5,000 mg L-1 that showed negative effect on 15 cm cuttings; layering and grafting were not successful in the studied conditions.

Advanced instrumentation for research in diving and hyperbaric medicine.

Improving the safety of diving and increasing knowledge about the adaptation of the human body to underwater and hyperbaric environment require specifically developed underwater instrumentation for physiological measurements. In fact, none of the routine clinical devices for health control is suitable for in-water and/or under-pressure operation. The present paper addresses novel technological acquisitions and the development of three dedicated devices: * an underwater data logger for recording O2 saturation (reflective pulsoxymetry), two-channel ECG, depth and temperature; * an underwater blood pressure meter based on the oscillometric method; and * an underwater echography system. Moreover, examples of recordings are presented and discussed.

Left ventricle changes early after breath-holding in deep water in elite apnea divers.

PURPOSE: To study by ultrasounds cardiac morphology and function early after breath-hold diving in deep water in elite athletes. METHODS: Fifteen healthy male divers (age 28 +/- 3 years) were studied using Doppler-echocardiography, immediately before (basal condition, BC) and two minutes after breath-hold diving (40 meters, acute post-apnea condition, APAC). Each subject performed a series of three consecutive breath-hold dives (20-30 and 40 m depth). RESULTS: End-diastolic left ventricular (LV) diameter (EDD) and end-diastolic LV volume (EDV) increased significantly (p < 0.01). Stroke volume (SV), cardiac index (CI), septal and posterior systolic wall-thickening (SWT) also significantly increased after diving (p < 0.01). No wall motion abnormalities were detected, and wall motion score index was unchanged between BC and APAC. Doppler mitral E wave increased significantly (p < 0.01), whereas the A wave was unchanged. Systemic vascular resistance (SVR) decreased significantly after diving (p < 0.05). In the factor analysis, filtering out the absolute values smaller than 0.7 in the loading matrix, it resulted that factor I consists of EDV, posterior SWT, SV and CI, factor II of diastolic blood pressure, waves A and E and factor III of heart rate and SVR. CONCLUSIONS: Systo-diastolic functions were improved in the early period after deep breath-hold diving due to favorable changes in loading conditions relative to pre-diving, namely the recruitment of left ventricular preload reserve and the reduction in afterload.

Underwater study of arterial blood pressure in breath-hold divers.

Knowledge regarding arterial blood pressure (ABP) values during breath-hold diving is scanty. It derives from a few reports of measurements performed at the water's surface, showing slight or no increase in ABP, and from a single study of two simulated deep breath-hold dives in a hyperbaric chamber. Simulated dives showed an increase in ABP to values considered life threatening by standard clinical criteria. For the first time, using a novel noninvasive subaquatic sphygmomanometer, we successfully measured ABP in 10 healthy elite breath-hold divers at a depth of 10 m of freshwater (mfw). ABP was measured in dry conditions, at the surface (head-out immersion), and twice at a depth of 10 mfw. Underwater measurements of ABP were obtained in all subjects. Each measurement lasted 50-60 s and was accomplished without any complications or diver discomfort. In the 10 subjects as a whole, mean ABP values were 124/93 mmHg at the surface and 123/94 mmHg at a depth of 10 mfw. No significant statistical differences were found when blood pressure measurements at the water surface were compared with breath-hold diving conditions at a depth of 10 mfw. No systolic blood pressure values >140 mmHg or diastolic blood pressure values >115 mmHg were recorded. In conclusion, direct measurements of ABP during apnea diving showed no or only mild increases in ABP. However, our results cannot be extended over environmental conditions different from those of the present study.

[Implementation and use of an electronic medical record in a department of cardiology: ten-year experience]. / Sviluppo, applicazione e valutazione di un sistema integrato gestionale e clinico nel campo delle malattie cardiovascolari: dieci anni di esperienza.

The rising of healthcare and hospital efficiency has underlined the necessity of clinical information systems. Hospitals represent complex organizations requiring control of different types of data for the management of patients and resources. A project was developed at the CNR Institute of Clinical Physiology of Pisa to produce an integration system to manage healthcare in its technological, administrative and clinical aspects, in respect of high quality in healthcare and cost-effectiveness evaluation. A networked computer-based information system was implemented to integrate different heterogeneous sources of patient data, both administrative and clinical (texts, signals, images), reaching a total integration. Data are stored into a relational database, processed and presented to healthcare personnel by network-connected clinical workstations. Epidemiological components are integrated to continuously offer evaluation processes to clinical components. From 1998 to August 2007 more than 300 stations were connected. The electronic medical records of more than 20 000 patients were recorded; more than 100 000 procedures were digitally integrated and the entire health file record and cost calculation could be obtained for each patient. In conclusion, the use of electronic medical records allowed a complete clinical data integration with improvement of overall structure efficiency and healthcare quality.