Effects of fat loss and low energy availability on the serum cardiometabolic profile of physique athletes.

Low energy availability (LEA) is a health concern for athletes, although it may paradoxically lead to improved cardiometabolic health in the general population. We investigated the associations between LEA, body composition, and serum cardiometabolic profile in 23 physique athletes (DIET) and 21 controls (CONT) during a 5-month pre-competition diet (MID), followed by 1 week of increased energy availability (COMP) and a 5-month weight regain period (POST). Quantification of 250 serum metabolome variables was conducted by NMR spectroscopy, body composition by dual-energy x-ray absorptiometry, dietary intake by food diaries, and exercise levels by training logs. Body fat percentage decreased from 19.5 ± 7.0% to 8.3 ± 5.3% (p < 0.001) in DIET through increased exercise levels and decreased energy intake, while CONT maintained those constant. In MID, DIET had increased (FDR < 0.01) HDL cholesterol, HDL particle size and number, and decreased (FDR < 0.05) VLDL lipids, serum triglycerides, and low-grade inflammation (glycoprotein acetyls) compared to baseline and CONT. The changes were associated with reduced android fat mass (-78 ± 13%) and energy intake (-28 ± 10%). In COMP, most of the metabolic changes found in MID persisted, except for altered triglycerides in all lipoprotein classes. After weight regain in POST, serum metabolome, body composition, energy intake, and exercise levels had reverted to baseline levels. In conclusion, fat loss and LEA may have beneficial yet transient effects on the serum cardiometabolic profile of lean individuals. Especially the HDL lipidome and lipoprotein triglycerides offer potential novel biomarkers for detecting LEA in athletes.

Substantial fat mass loss reduces low-grade inflammation and induces positive alteration in cardiometabolic factors in normal-weight individuals.

The accumulation of fat, especially in visceral sites, is a significant risk factor for several chronic diseases with altered cardiometabolic homeostasis. We studied how intensive long-term weight loss and subsequent weight regain affect physiological changes, by longitudinally interrogating the lipid metabolism and white blood cell transcriptomic markers in healthy, normal-weight individuals. The current study examined 42 healthy, young (age: 27.5 ± 4.0 years), normal-weight (body mass index, BMI: 23.4 ± 1.7 kg/m2) female athletes, of which 25 belong to the weight loss and regain group (diet group), and 17 to the control group. Participants were evaluated, and fasting blood samples were drawn at three time points: at baseline (PRE); at the end of the weight loss period (MID: 21.1 ± 3.1 weeks after PRE); and at the end of the weight regain period (POST: 18.4 ± 2.9 weeks after MID). Following the weight loss period, the diet group experienced a ~73% reduction (~0.69 kg) in visceral fat mass (false discovery rate, FDR < 2.0 × 10-16), accompanied by anti-atherogenic effects on transcriptomic markers, decreased low-grade inflammation (e.g., as α1-acid glycoprotein (FDR = 3.08 × 10-13) and hs-CRP (FDR = 2.44 × 10-3)), and an increase in functionally important anti-atherogenic high-density lipoprotein -associated metabolites (FDR < 0.05). This occurred even though these values were already at favorable levels in these participants, who follow a fitness-lifestyle compared to age- and BMI-matched females from the general population (n = 58). Following the weight regain period, most of the observed beneficial changes in visceral fat mass, and metabolomic and transcriptomic profiles dissipated. Overall, the beneficial anti-atherogenic effects of weight loss can be observed even in previously healthy, normal-weight individuals.

Retinal pigment epithelial marginal retraction after photodynamic therapy for choroidal neovascularization in pathologic myopia.

PURPOSE: To report the incidence of retinal pigment epithelial (RPE) marginal retraction after verteporfin photodynamic therapy (PDT) for subfoveal choroidal neovascularization (CNV) in pathologic myopia (PM). METHODS: Retrospective review of 236 patients treated with PDT for subfoveal CNV due to PM. RESULTS: RPE marginal retraction was found in 3 eyes (1.3%), and a decrease of a mean of five lines of vision was reported to occur 10-15 days after treatment. At the end of followup two eyes lost three lines and one six lines from baseline. CONCLUSIONS: RPE marginal retraction as an early complication of PDT for subfoveal CNV secondary to PM is rare. The low incidence of this adverse event, however, should not preclude recommendations for PDT in myopic eyes that could benefit from this treatment modality.

Quality of vision: A consensus building initiative for a new ophthalmologic concept.

PURPOSE: Many studies have addressed the quantification of visual acuity, and the conventional method of measuring it has so far demonstrated serious limitations. Vision testing requires new methods that can more precisely express the quality of vision as perceived by the patient. METHODS: This study employed the Delphi method of consensus building. Concepts associated with quality of vision (QoV) were identified by a board of experts and proposed to participating specialists in two subsequent questionnaires. Upon receipt of the completed questionnaires, the replies were classified to determine the building blocks of a consensus. RESULTS: By analyzing the replies to the two questionnaires, the authors determined the key elements of QoV on which a consensus was found among the respondents. CONCLUSIONS: A consensus was reached on the opinion that the quantification of visual acuity by traditional means is inadequate for investigating QoV. Although visual acuity is still a basic element for testing, the experts believe that contrast sensitivity, reading speed, and microperimetry are additional parameters necessary for quantifying QoV. The use of a psychometric questionnaire on visual function could allow a better interpretation of visual impairment.

Fluorescein angiography and indocyanine green angiography for identifying occult choroidal neovascularization in age-related macular degeneration.

PURPOSE: To assess whether fluorescein angiography (FA) alone without indocyanine green angiography (ICGA) can identify and localize occult choroidal neovascularization (CNV) in age-related macular degeneration (ARMD). METHODS: Seventy-nine eyes of 77 consecutive patients with occult CNV were evaluated independently by two skilled physicians at first with FA alone and then with FA combined with ICGA by fundus camera. RESULTS: The agreement between FA and ICGA was 73% and 68% for the two physicians (K=0.585 and 0.512, respectively). The first operator correctly identified 20/27 as plaque CNV; six had different sizes and locations. The second operator identified 25/30, with one mistaken for size and location. For focal CNV the first operator identified 34/39, and the second one 23/35. CONCLUSIONS: Comparing the FA results with ICGA, CNV was correctly identified in about 60% of cases. Therefore, ICGA should be considered an indispensable diagnostic test to identify the presence, the type, and the location of occult CNV.

Fluorescein angiography and indocyanine green angiography for identifying occult CNV in ARMD.

PURPOSE: To assess whether fluorescein angiography (FA) alone without indocyanine green angiography (ICGA) can identify and localize occult choroidal neovascularization (CNV) in age-related macular degeneration (ARMD). METHODS: Seventy-nine eyes of 77 consecutive patients with occult CNV were evaluated independently by two skilled physicians at first with FA alone and then with FA combined with ICGA by fundus camera. RESULTS: The agreement between FA and ICGA was 73% and 68% for the two physicians (K=0.585 and 0.512, respectively). The first operator correctly identified 20/27 as plaque C N V; six had different sizes and locations. The second operator identified 25/30, with one mistaken for size and location. For focal CNV the first operator identified 34/39, and the second one 23/35. CONCLUSIONS: Comparing the FA results with ICGA, CNV was correctly identified in about 60% of cases. Therefore, ICGA should be considered an indispensable diagnostic test to identify the presence, the type, and the location of occult CNV.

Transpupillary retinopexy of chorioretinal lesions predisposing to retinal detachment with the use of diode (810 nm) microlaser.

PURPOSE: To evaluate the clinical efficacy and safety of diode microlaser for transpupillary retinopexy in eyes with retinal degenerations and retinal tears in a prospective clinical study. METHODS: Twenty eyes (19 patients) with mid or peripheral degenerations and retinal tears were treated with infrared diode photocoagulation. A continuous-wave diode laser was used to create clinically just visible chororetinal bums. The follow-up period was extended to 3 months. Color photographs of the coagulated retina were taken 24 hours after laser retinopexy and at 1 month and 3 months postoperatively. RESULTS: Acute chorioretinal burns appeared gray-white on the midperiphery, not sharply defined and sometimes somewhat difficult to detect during photocoagulation. Power levels ranged from 110 to 640 mW (mean +/- SD 384+/-133.47 mW). In eyes with dark brown irises, the mean laser power was significantly lower than in eyes with blue-green irises (325.83+/-117.90 mW versus 471.25+/-109.60 mW, P < 0.05). At the 1 -month postoperative follow-up examination, all eyes showed chororetinal scarring with pigmentary mottling. At 3 months, the diode lesions' appearance was that of a marked atrophic chonoretinal scar. There were no adverse side effects in the laser-treated eyes except for a small choroidal-retinal-vitreal bleeding in 1 (5%) of the eyes. CONCLUSIONS: Transpupillary photocoagulation to mid or peripheral retina with diode microlaser has proven to be effective at providing retinopexy of retinal degenerations and retinal tears. The long wave 810 nm can also be used successfully and safely for the prophylaxis of retinal detachment because it can create a strong adhesion between the retina and choroid. However, diode laser should not be employed routinely for treating patients with clear media or fundus hypopigmentation. The use of diode is preferably indicated in eyes with media opacities because infrared light has the advantage of a better transmission through lens opacity or vitreous hemorrhage. As diode laser energy can produce variable tissue effects, there may be some difficulty in obtaining reproducible bums because of unpredictable changes in melanin density of the retinal pigment epithelium and choroid.

Congenital malformation of the iris's major arterial circle simulating an angioma.

A case of anatomical anomaly of the iris's major arterial circle simulating an angioma was discovered in the right eye of a 64-year-old asymptomatic woman during routine ocular examination. We report its clinical and gonioangioiridographic findings.

[Cognitive functions in Turner's syndrome]. / Funzioni cognitive nella sindrome di Turner.

BACKGROUND: In this article, the interrelations between biological and emotional factors in learning disabilities in Turner's syndrome are studied. METHODS: This is a transversal study with a 18 months neuropsychiatric follow-up. Five girls with the syndrome, aged between 12 and 22 years have been studied using Wechsler scales (WISC-R and WAIS), individual interviews and psychodiagnostic tests, to describe both their cognitive profile and psychological traits. RESULTS: The intelligence tests show selective impairments in visuo-spatial area, with lower score on performance IQ, especially in the sub-tests "Block Design" and "Object Assembly"; individual interviews and psychodiagnostic tests show signs of psychological disease, often consequences of this syndrome, and only in one girl with an associated diagnosis of psychosis. CONCLUSIONS: Psychological and environmental factors, as well as the genetics, may play an important role in the impairment of cognitive abilities, and the neuropsychological aspects may not be related only with the organic substrate.

Hemangioma of the ciliary body: a case report and review of the literature.

This paper documents a case of ciliary body hemangioma discovered in the eye of a 72-year-old white man during routine ocular examination. The correct differential diagnosis was not made clinically despite the use of A and B scan ultrasonography and also a fluorescein-angiographic study. This rare tumor was removed by a sector cyclectomy after apparent growth, onset of anterior uveitis and demonstration of fluorescein dye leakage. Histopathologic examination revealed that the tumor consisted of capillaries and large vascular loculi containing numerous erythrocytes. The histopathologic diagnosis was a mixed capillary-cavernous hemangioma of the ciliary body. The results suggest that when a ciliary body tumor is suspected to be malignant, an attempt can be made to excise it. This report encourages the conservative surgical treatment of the ciliary body tumor avoiding the sacrifice of the entire ocular globe.

Benign adenoma of the iris pigment epithelium: clinical and iris fluorescein angiographic features.

Benign adenoma of iris pigment epithelium is a rare neoformation characterized by a multinodular, dark brown to dark black, relatively stationary lesion, especially localized in the peripheral iris. We report a case of iris pigment epithelium adenoma with no evidence of change during the 6-year follow-up. Iris fluorescein angiography showed a mild staining of the lesion without evidence of abnormal vessels. The importance of fluorescence iridography in the differential diagnosis of iris-pigmented lesions is discussed.

[Functional evaluation of a new type of intraocular lens: Domilens type PROGRESS 1]. / Evaluation fonctionnelle d'un nouveau type de lentille intraoculaire: Domilens type PROGRESS 1.

This study presents the first clinical and functional results on the implantation of a new multifocal IOL model, the Domilens type PROGRESS 1. A group of 20 patients underwent extracapsular extraction of cataract with continuous circular capsulorhexis and IOL implantation in the capsular bag. In 65% of the cases, final visual acuity from a far distance proved to be greater than or equal to 8/10 without correction, while visual acuity from a short distance was J2 without the need of additional lenses. BAT identified a decrease in visual acuity of 0.01 Snellen lines at a medium lighting level and 0.05 at the maximum level. The perimetric results obtained with the C 30-2 threshold programme of the Humphrey field analyzer showed a foveal sensitivity threshold of 32.5 dB +/- 9.25 dB and a mean defect of -2.22 dB +/- 2.90 dB. The Vistech VCTS 6500 underlined a decrease in the sensitivity to space frequency contrast of 6.0 c/d versus a control group of patients with monofocal IOL (P < 0.05). This reduction involved a wider range of space frequencies (3.0, 6.0, 12.0 c/d) in comparison with a group of phakic subjects (P < 0.05). With the on-off PEV patterns, a slight decrease in contrast sensitivity threshold was found versus patients with monofocal IOL statistically non significant (P > 0.05). At a medium space frequency of 2.33 c/d, a decrease in contrast sensitivity versus phakic subjects (P < 0.05) was observed. Depth of focus went from infinite to 19 cm. from the eye.

Branch retinal vein occlusion and exudative retinal detachment: pathogenetical aspects.

Exudative retinal detachment (ERD) is an uncommon complication of branch retinal vein occlusion (BRVO). The ERD pathogenesis has been mainly related to the haemodynamic overload and to an impairment in the function of the retinal pigment epithelium. Data relative to 98 cases of BRVO without ERD were compared with the correspondent data of 10 cases of BRVO with ERD. Venous leakage showed a substantial equivalency between the two groups, while evaluation of retinal venous collaterals demonstrated a lower amount in the BRVO cases with ERD, with a statistically significant difference. Moreover, considering the various ERD localizations, we suggest that the ERD pathogenesis is mainly ascribable to the scant development of retinal venous collaterals but that an important role may also be played by the retinal pigment epithelium impairment consequent to the retinal ischaemia.

Metabolism of 2-aminofluorene by human polymorphonuclear leukocytes: more evidence for the association between inflammation and cancer.

Recent investigations have demonstrated the ability of leukocytes to metabolize promutagens or procarcinogens into their genotoxic forms. As a possible explanation for the association between inflammation and cancer, we and others have hypothesized that local accumulations of leukocytes could take up nearby promutagens, metabolize them, and release genotoxic agents that may cause damage in the surrounding tissue. Using a modified, two-step preincubation protocol with Salmonella, we have tested this hypothesis. We have shown that total human peripheral blood leukocytes, cultured in the presence of 2-aminofluorene for 18 hr, can metabolize 2-aminofluorene into agents mutagenic to Salmonella typhimurium strain TA98. Furthermore, experiments in which polymorphonuclear leukocytes were separated from mononuclear leukocytes demonstrated that the PMNs metabolized 2-aminofluorene to a much greater extent than the MNs.

Partial ablation of benign osteoblastoma: a case report.

Osteoblastoma is a rare bone tumor involving spine, long bones and infrequently skull, especially with sinus localization. The orbital localization of the neoplasia may cause axial or paraxial exophthalmus, vertical diplopia, pulsatile orbital pain, soft tissue swelling with skin erythema. In addition the osteoblastoma may cause an optic nerve compression, with optic disc edema up to optic nerve atrophy. We describe a case of giant benign osteoblastoma with frontal occurrence and orbital involvement with optic nerve compression. Surgery was performed in order to obtain the partial ablation of the neoplasia. After a 4-year follow-up there was no evidence of recurrence.

[Cardiovascular adjustments in hypertensive patients. An echocardiographic study]. / Adattamenti cardiovascolari in ipertesi. Studio ecocardiografico.

Echocardiography was used to asses parameters of cardiovascular function in order to identify the main cardiac adjustment mechanisms to arterial hypertension. In addition to morphological parameters of septal and parietal thickness and diameter, telesystolic (Ses) and telediastolic (Spk) stress, EF, Vcfm, the index of left ventricular mass (ILVM), hypertrophy ratio (h/r), contractility index (Do), peripheral resistances (RPT) and Tarazi's index (SAC) were evaluated. In comparison to control subjects, higher levels of PwTs, h/r, SAC, RPT and ILVM (at the limit of significance) were found in hypertensive patients, which were reflected by higher Spk and Do values. From the further analysis of data to identify patients with signs of left ventricular hypertrophy (h/r greater than 0.40 and/or ILVM greater than 140) it was concluded that the hypertrophy ratio (h/r) is the functional parameter which most closely reveals the type of myocardial adjustment. Irrespective of absolute values of ILVM, the adequacy of myocardial hypertrophy to the dimensions of the cavity is accompanied by the normalisation of stress and the return of Do values close to normal levels. Hearts with low h/r those with the highest stress levels, as well as preesting the lowest EF and the highest Do values.

Positive patch test reactions to nickel, cobalt, and potassium dichromate in a series of 576 patients.

In 1988, 633 patients attending our Allergology Center underwent patch testing with the standard series recommended by the Gruppo Italiano Ricerca Dermatiti da Contatto e Ambientali. Of these, 576 patients completed the test correctly and their results were evaluated statistically. Nickel, cobalt, and potassium dichromate were the three most common sensitizers; concomitant positive reactions were present at significant levels. The authors discuss environmental and occupational exposure to contact allergens and correlate the major sites of dermatitis with the sensitivity to each metal in patients of both sexes.