Publications by authors named "Simona Bo"

98 Publications

The incidence of the refeeding syndrome. A systematic review and meta-analyses of literature.

Clin Nutr 2021 06 22;40(6):3688-3701. Epub 2021 Apr 22.

Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126 Turin, Italy.

Background & Aims: The refeeding syndrome (RFS) has been recognized as a potentially life-threatening metabolic complication of re-nutrition, but the definition widely varies and, its incidence is unknown. The aim of this systematic review and meta-analyses was to estimate the incidence of RFS in adults by considering the definition used by the authors as well as the recent criteria proposed by the American Society of Parenteral and Enteral Nutrition (ASPEN) consensus. Furthermore, the incidence of refeeding hypophosphatemia (RH) was also assessed.

Methods: Four databases were systematically searched until September 2020 for retrieving trials and observational studies. The incidences of RFS and RH were expressed as percentage and reported with 95% confidence intervals (CI).

Results: Thirty-five observational studies were included in the analysis. The risk of bias was serious in 16 studies and moderate in the remaining 19. The incidence of RFS varied from 0% to 62% across the studies. No substantial change in the originally reported incidence of RFS was found by applying the ASPEN criteria. Similarly, the incidence of RH ranged between 7% and 62%. In the subgroup analyses, inpatients from Intensive Care Units (ICUs) and those initially fed with >20 kcal/kg/day seemed to have a higher incidence of both RFS (pooled incidence = 44%; 95% CI 36%-52%) and RH (pooled incidence = 27%; 95% CI 21%-34%). However, due to the high heterogeneity of data, summary incidence measures are meaningless.

Conclusion: The incidence rate of both RFS and RH greatly varied according to the definition used and the population analyzed, being higher in ICU inpatients and in those with increased initial caloric supply. Therefore, a universally accepted definition for RFS, taking different clinical contexts and groups of patients into account, is still needed to better characterize the syndrome and its approach.
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http://dx.doi.org/10.1016/j.clnu.2021.04.023DOI Listing
June 2021

Use of online and paper-and-pencil questionnaires to assess the distribution of orthorexia nervosa, muscle dysmorphia and eating disorders among university students: can different approaches lead to different results?

Eat Weight Disord 2021 Jun 10. Epub 2021 Jun 10.

Department of Public Health and Pediatrics, University of Turin, Via Santena 5bis, 10126, Turin, Italy.

Purpose: Administration of questionnaires to assess the diffusion of disordered eating behaviours via the web is becoming common today. The aim of this study is to assess whether two different approaches of administering a test to assess traits of eating disorders (EDs), orthorexia nervosa (ON) and muscle dysmorphia (MD) by email recruitment and online completion (web-based survey-WBS) and by in person recruitment and paper-and-pencil completion (paper-based survey-PBS), gives different results.

Methods: During 2 consecutive academic years, a self-reported questionnaire consisting of questions about personal characteristics and three tests for the evaluation of ON (ORTO-15), MD (MDDI-ITA), and EDs (EAT-26) were administered to two groups of undergraduates, respectively, as a WBS and a PBS.

Results: The WBS response rate was 6.7% (N = 137), and the PBS response rate was 86.5% (N = 372). The WBS group showed a statistically significant higher prevalence of students with eating disordered behaviours (21.2% vs 5.4%) and registered a higher mean score on the EAT-26 test (13.5 ± 11.1 vs 6.0 ± 8.0); no differences between the two groups emerged for ON and MD prevalence and test scores. Moreover, in the WBS group, the number of students with one or more tests with test scores above the cut-off values was significantly higher (46.0% vs 32.3%).

Conclusion: The choice of the approach to administer a questionnaire to assess the diffusion of EDs and related issues must take into account all the factors that can result in selection bias and that can affect the reliability of the results.

Level Of Evidence: Level V, descriptive cross-sectional survey.
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http://dx.doi.org/10.1007/s40519-021-01231-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8190766PMC
June 2021

Mediterranean Diet and SARS-COV-2 Infection: Is There Any Association? A Proof-of-Concept Study.

Nutrients 2021 May 19;13(5). Epub 2021 May 19.

Department of Medical Sciences, University of Torino, 10126 Torino, Italy.

The aim of this observational study was investigating the possible correlation between adherence to the Mediterranean diet (MeD) and SARS-COV-2 infection rates and severity among healthcare professionals (HCPs). An online self-administrated questionnaire (evaluating both MeD adherence and dietary habits) was filled out by HCPs working in Piedmont (Northern Italy) from 15 January to 28 February 2021. Out of the 1206 questionnaires collected, 900 were considered reliable and analyzed. Individuals who reported the SARS-COV-2 infection ( = 148) showed a significantly lower MeD score, with a lower adherence in fruit, vegetables, cereals, and olive oil consumption. In a logistic regression model, the risk of infection was inversely associated with the MeD score (OR = 0.88; 95% CI 0.81-0.97) and the consumption of cereals (OR = 0.64; 0.45-0.90). Asymptomatic individuals with SARS-COV-2 infection reported a lower intake of saturated fats than symptomatic; individuals requiring hospitalization were significantly older and reported worse dietary habits than both asymptomatic and symptomatic individuals. After combining all symptomatic individuals together, age (OR = 1.05; 1.01-1.09) and saturated fats intake (OR = 1.09; 1.01-1.17) were associated with the infection severity. HCPs who reported a SARS-COV-2 infection showed a significantly lower MeD score and cereal consumption. The infection severity was directly associated with higher age and saturated fat intake.
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http://dx.doi.org/10.3390/nu13051721DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8160854PMC
May 2021

The Use of Self-Help Strategies in Obesity Treatment. A Narrative Review Focused on Hypnosis and Mindfulness.

Curr Obes Rep 2021 Sep 29;10(3):351-364. Epub 2021 May 29.

Department of Medical Sciences, University of Torino, c.so AM Dogliotti 14, 10126, Torino, Italy.

Purpose Of Review: The aim of this narrative review was to summarize the evidence evaluating the possibilities and limitations of self-hypnosis and mindfulness strategies in the treatment of obesity.

Recent Findings: Psychological factors, such as mood disorders and stress, can affect eating behaviors and deeply influence weight gain. Psychological approaches to weight management could increase the motivation and self-control of the patients with obesity, limiting their impulsiveness and inappropriate use of food. The cognitive-behavioral therapy (CBT) represents the cornerstone of obesity treatment, but complementary and self-directed psychological interventions, such as hypnosis and mindfulness, could represent additional strategies to increase the effectiveness of weight loss programs, by improving dysfunctional eating behaviors, self-motivation, and stimulus control. Both hypnosis and mindfulness provide a promising therapeutic option by improving weight loss, food awareness, self-acceptance of body image, and limiting food cravings and emotional eating. Greater effectiveness occurs when hypnosis and mindfulness are associated with other psychological therapies in addition to diet and physical activity. Additional research is needed to determine whether these strategies are effective in the long term and whether they can be routinely introduced into the clinical practice.
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http://dx.doi.org/10.1007/s13679-021-00443-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8408071PMC
September 2021

Non-Celiac Gluten/Wheat Sensitivity: Clinical Characteristics and Microbiota and Mycobiota Composition by Response to the Gluten Challenge Test.

Nutrients 2021 Apr 12;13(4). Epub 2021 Apr 12.

Department of Medical Sciences, University of Torino, 10126 Torino, Italy.

The aims of this observational "proof-of-concept" study were to analyze the clinical/psychological characteristics and gut microbiota/mycobiota composition of individuals with suspected non-celiac gluten/wheat sensitivity (NCGS/WS) according to responses to the double-blind-placebo-controlled (DBPC) crossover gluten challenge test. Fifty individuals with suspected NCGS/WS were subjected to the DBPC challenge test; anthropometric measurements, psychometric questionnaires, and fecal samples were collected. Twenty-seven (54%) participants were gluten responsive (NCGS), and 23 were placebo responsive, with an order effect. NCGS individuals displayed a significantly lower risk of eating disorders and a higher mental health score when compared to placebo-responsive participants, confirmed by multiple logistic regression analyses (OR = 0.87; 95% CI 0.76-0.98, = 0.021, and OR = 1.30; 95% CI 1.06-1.59, = 0.009, respectively). Principal coordinate analyses based on microbiota composition showed a separation by the DBPC response ( = 0.039). For ( = 0.05) and ( = 0.007), the frequency of amplicon sequence variants was lower, and that for ( = 0.009) and ( = 0.004) was higher in NCGS individuals at multiple regression analyses. No difference in the mycobiota composition was detected between the groups. In conclusion, almost half of the individuals with suspected gluten sensitivity reported symptoms with placebo; they showed lower mental health scores, increased risk for eating disorders, and a different gut microbiota composition.
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http://dx.doi.org/10.3390/nu13041260DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8070191PMC
April 2021

Associations between Pre-Bariatric High-Sensitivity C-Reactive Protein and Post-Surgery Outcomes.

Diagnostics (Basel) 2021 Apr 18;11(4). Epub 2021 Apr 18.

Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran.

Background: Obesity is a chronic inflammatory condition associated with increased circulating levels of C-reactive protein (CRP). Bariatric surgery has been reported to be effective in improving both inflammatory and liver status. Our aims were to elucidate the relationships between pre-surgery high sensitivity-CRP (hs-CRP) values and post-surgery weight loss and liver steatosis and fibrosis in patients with severe obesity undergoing Roux-en-Y gastric bypass.

Methods: We conducted an observational prospective study on 90 individuals with morbid obesity, who underwent gastric bypass. Anthropometric indices, laboratory assessment (lipid panel, glycemic status, liver enzymes, and hs-CRP), liver stiffness and steatosis were evaluated at baseline and 6-months after surgery.

Results: There was a significant post-surgery reduction in all the anthropometric variables, with an average weight loss of 33.93 ± 11.79 kg; the mean percentage of total weight loss (TWL) was 27.96 ± 6.43%. Liver elasticity was significantly reduced (from 6.1 ± 1.25 to 5.42 ± 1.52 kPa; = 0.002), as well as liver aminotransferases, nonalcoholic fatty liver disease fibrosis score (NFS) and the grade of steatosis. Serum hs-CRP levels significantly reduced (from 9.26 ± 8.45 to 3.29 ± 4.41 mg/L; < 0.001). The correlations between hs-CRP levels and liver fibrosis (elastography), steatosis (ultrasonography), fibrosis-4 index, NFS, and surgery success rate were not significant. Regression analyses showed that serum hs-CRP levels were not predictive of liver status and success rate after surgery in both unadjusted and adjusted models.

Conclusions: In patients with morbid obesity, bariatric surgery caused a significant decrease in hs-CRP levels, liver stiffness and steatosis. Baseline hs-CRP values did not predict the weight-loss success rate and post-surgery liver status.
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http://dx.doi.org/10.3390/diagnostics11040721DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073671PMC
April 2021

Impact of Refeeding Syndrome on Short- and Medium-Term All-Cause Mortality: A Systematic Review and Meta-Analysis.

Am J Med 2021 08 15;134(8):1009-1018.e1. Epub 2021 Apr 15.

Department of Medical Sciences, University of Turin, Turin, Italy.

Background: The refeeding syndrome has been described as a potentially life-threatening complication of renutrition. However, moving from single reports to larger population studies, the real impact of refeeding syndrome on all-cause mortality is still unknown.

Methods: PubMed/Medline, EMBASE, Cochrane library, and CINAHL databases were systematically searched until September 2020 for studies reporting mortality rates in patients who developed the syndrome at renutrition compared with those who did not develop it. Effect sizes were pooled through a random-effect model.

Results: Thirteen studies were finally considered in the meta-analysis, for a total of 3846 patients (mean age 64.5 years; 58% males). Pooled data showed a nonsignificant trend toward an increased short-term (≤1 month) mortality in patients developing the refeeding syndrome (odds ratio = 1.27, 95% confidence interval 0.93-1.72), mostly driven by studies in which renutrition was not prescribed and supervised by a nutritional support team (P = .01 at subgroup analysis) and by studies published in previous years (P = .04 at meta-regression). When examining medium-term (≤6 month) mortality, an overall statistical significance toward higher risk was observed (odds ratio = 1.54, 95% confidence interval 1.04-2.28).

Conclusion: This was the first meta-analysis that specifically assessed the impact of refeeding syndrome on mortality. Our results suggested a nonsignificant trend toward increased mortality in the short term but a significantly increased mortality in the medium term. The supervision/management of the refeeding process by a nutrition specialist might be a key factor for the limitation of this mortality excess.
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http://dx.doi.org/10.1016/j.amjmed.2021.03.010DOI Listing
August 2021

Effects of statins on mitochondrial pathways.

J Cachexia Sarcopenia Muscle 2021 04 29;12(2):237-251. Epub 2021 Jan 29.

Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.

Statins are a family of drugs that are used for treating hyperlipidaemia with a recognized capacity to prevent cardiovascular disease events. They inhibit β-hydroxy β-methylglutaryl-coenzyme A reductase, i.e. the rate-limiting enzyme in mevalonate pathway, reduce endogenous cholesterol synthesis, and increase low-density lipoprotein clearance by promoting low-density lipoprotein receptor expression mainly in the hepatocytes. Statins have pleiotropic effects including stabilization of atherosclerotic plaques, immunomodulation, anti-inflammatory properties, improvement of endothelial function, antioxidant, and anti-thrombotic action. Despite all beneficial effects, statins may elicit adverse reactions such as myopathy. Studies have shown that mitochondria play an important role in statin-induced myopathies. In this review, we aim to report the mechanisms of action of statins on mitochondrial function. Results have shown that statins have several effects on mitochondria including reduction of coenzyme Q10 level, inhibition of respiratory chain complexes, induction of mitochondrial apoptosis, dysregulation of Ca metabolism, and carnitine palmitoyltransferase-2 expression. The use of statins has been associated with the onset of additional pathological conditions like diabetes and dementia as a result of interference with mitochondrial pathways by various mechanisms, such as reduction in mitochondrial oxidative phosphorylation, increase in oxidative stress, decrease in uncoupling protein 3 concentration, and interference in amyloid-β metabolism. Overall, data reported in this review suggest that statins may have major effects on mitochondrial function, and some of their adverse effects might be mediated through mitochondrial pathways.
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http://dx.doi.org/10.1002/jcsm.12654DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061391PMC
April 2021

Strategies for Reducing Salt and Sugar Intakes in Individuals at Increased Cardiometabolic Risk.

Nutrients 2021 Jan 19;13(1). Epub 2021 Jan 19.

Department of Medical Sciences, University of Turin, 10126 Turin, Italy.

Non-communicable diseases (NCDs) are the first causes of death worldwide. Reduction in the dietary intake of salt and sugars is important lifestyle advice that is useful for NCD prevention. However, the simple recommendations of reducing salt and sugars by healthcare professionals are often ineffective; innovative strategies are therefore necessary. This review aimed at describing the current knowledge about the strategies to reduce dietary salt and sugar intake, including both strategies for the food industry to reduce the salt or sugar of its products and recommendations for health professionals in a clinical context, such as the replacement with substitutes in foods, the gradual reduction to allow a progressive consumer adaptation towards less intense taste, and the different spatial distribution of tastants within the food matrix with taste intensity enhancement. In addition, the cross-modal interaction between two or more different sensory modalities as an innovative strategy for enhancing sweetness and saltiness perception was described. Finally, the dietary tips for salt and sugar reduction were summarized in order to create a comprehensive guide of dietary advices for healthcare professionals for optimizing the management of patients at increased cardiometabolic risk.
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http://dx.doi.org/10.3390/nu13010279DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835960PMC
January 2021

Plasma and Red Blood Cell PUFAs in Home Parenteral Nutrition Paediatric Patients-Effects of Lipid Emulsions.

Nutrients 2020 Dec 5;12(12). Epub 2020 Dec 5.

Artificial Nutrition Division, Ospedale Bambino Gesù, 00165 Roma, Italy.

: Mixed lipid emulsions (LE) containing fish oil present several advantages compared to the sole soybean oil LE, but little is known about the safety of essential fatty acids (EFA) profile in paediatric patients on long-term Parenteral Nutrition (PN). : to assess glycerophosfolipid polyunsaturated fatty acids (PUFA) levels on plasma and red blood cell (RBC) membrane of children on long term PN with composite LE containing fish oil (SMOF), and to compare it with a group receiving olive oil LE (Clinoleic) and to the reference range for age, previously determined on a group of healthy children. : A total of 38 patients were enrolled, median age 5.56 (0.9-21.86) years, 15 receiving Clinoleic, 23 receiving SMOF. Patients on SMOF showed significantly higher levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), lower levels of arachidonic acid (ARA) and Mead acid (MEAD)/ARA ratio in plasma and RBC compared with patients on Clinoleic and with healthy children. Triene:tetraene (T:T) ratio of both groups of patients did not differ from that of healthy children-median plasma (MEAD/ARA: 0.01, interquartile rage (IQR) 0.01, = 0.61 and 0.02, IQR 0.02, = 0.6 in SMOF and Clinoleic patients, respectively), and was considerably lower than Holman index (>0.21). SMOF patients showed no statistically significant differences in growth parameters compared with Clinoleic patients. Patients of both groups showed stiffness class F0-F1 of liver stiffness measure (LSM) 5.6 (IQR 0.85) in SMOF patients and 5.3 (IQR 0.90) in Clinoleic patients, = 0.58), indicating absence of liver fibrosis. : Fatty acids, measured as concentrations (mg/L), revealed specific PUFA profile of PN patients and could be an accurate method to evaluate nutritional status and eventually to detect essential fatty acid deficiency (EFAD). SMOF patients showed significantly higher EPA, DHA and lower ARA concentrations compared to Clinoleic patients. Both LEs showed similar hepatic evolution and growth.
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http://dx.doi.org/10.3390/nu12123748DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7762095PMC
December 2020

The Refeeding Syndrome: a neglected but potentially serious condition for inpatients. A narrative review.

Intern Emerg Med 2021 01 19;16(1):49-60. Epub 2020 Oct 19.

Department of Medical Sciences, University of Torino, c.so AM Dogliotti 14, 10126, Turin, Italy.

The Refeeding Syndrome (RFS) is a potentially serious, but still overlooked condition, occurring in individuals who are rapidly fed after a period of severe undernourishment. RFS derives from an abnormal electrolyte and fluid shifts leading to many organ dysfunctions. Symptoms generally appear within 2-5 days of re-feeding and may be absent/mild or severe and life threating, depending on the pre-existing degree of malnutrition and comorbidities. The lack of a standard definition and the nonspecificity of the symptoms make both incidence estimate and diagnosis difficult. In 2020, the American Society for Parenteral and Enteral Nutrition (ASPEN) proposed a unifying definition for the RFS and its severity classification. The awareness of the condition is crucial for identifying patients at risk, preventing its occurrence, and improving the management. The objectives of this narrative review were to summarize the current knowledge and recommendations about the RFS and to provide useful tips to help physicians to recognize and prevent the syndrome.
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http://dx.doi.org/10.1007/s11739-020-02525-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843537PMC
January 2021

The effect of caloric restriction and fasting on cancer.

Semin Cancer Biol 2021 Aug 22;73:30-44. Epub 2020 Sep 22.

Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address:

Cancer is one of the most frequent causes of worldwide death and morbidity and is a major public health problem. Although, there are several widely used treatment methods including chemo-, immune- and radiotherapies, these mostly lack sufficient efficiency and induce toxicities in normal surrounding tissues. Thus, finding new approaches to mitigate side effects and potentially accelerate treatment is paramount. In line with this, increasing preclinical evidence indicates that caloric restriction (CR) and fasting might have anticancer effects by reducing tumor progression, enhancing death of cancer cells, and elevating the effectiveness and tolerability of chemo- and radiotherapies. Nonetheless, clinical studies assessing the potential of CR and fasting in cancer are scarce and inconsistent, and more investigations are still required to clarify their effect in different aspects of cancer treatment. In this review, we have summarized the findings of preclinical and clinical studies of CR and fasting with respect to efficacy and on the adverse effects of standard cancer treatments.
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http://dx.doi.org/10.1016/j.semcancer.2020.09.010DOI Listing
August 2021

Predictors of attrition from a weight loss program. A study of adult patients with obesity in a community setting.

Eat Weight Disord 2021 Aug 20;26(6):1729-1736. Epub 2020 Aug 20.

Department of Medical Sciences, University of Torino, c.so AM Dogliotti 14, 10126, Turin, Italy.

Purpose: Obesity unit attrition is frequent and contributes to treatment failure. Many studies evaluating attrition predictors were part of randomized trials, and different terminology and criteria were used in the engagement field. We aimed to investigate the factors potentially implicated in early (< 12 weeks) and late (> 12 weeks) attrition from an obesity unit in a community setting METHODS: This was a retrospective cohort study of 250 patients with obesity who were followed-up at our obesity unit. Our program included at least 6 meetings in 12 months. Sociodemographic and anthropometric data, and psychometric questionnaires were collected from all participants.

Results: One-hundred thirty-four (53.6%) participants dropped out. Those individuals showed lower BMI, lower overall health status, and increased depression scores. In a multiple regression model, BMI (inversely; OR = 0.90; 95%CI 0.84-0.96) and depression score (directly, OR = 1.05; 1.00-1.10) were associated with attrition risk. Early dropouts (n = 47) had lower weights, smaller waist circumferences and worse mental health scores than late dropouts (n = 87) and more frequently lived alone. When compared to completers, early dropouts had lower weights, BMIs, waist circumferences, overall health and mental status scores, increased depression scores and percentage of individuals living alone. In a multiple regression, lower BMI (OR = 0.83; 0.75-0.92), lower mental status score (OR = 3.17; 1.17-8.59) and living alone (OR = 2.25; 1.02-4.97) were associated with early attrition risk.

Conclusion: Lower BMI and increased depression score were associated with attrition. Early attrition was associated with lower weight, decreased mental well-being, and living alone. Individuals with these characteristics might need tailored approaches to enhance their engagement.

Level Of Evidence: Level V, retrospective descriptive study.
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http://dx.doi.org/10.1007/s40519-020-00990-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8292291PMC
August 2021

Changes in Weight and Nutritional Habits in Adults with Obesity during the "Lockdown" Period Caused by the COVID-19 Virus Emergency.

Nutrients 2020 Jul 7;12(7). Epub 2020 Jul 7.

Department of Medical Sciences, University of Torino, c.so AM Dogliotti 14, 10126 Torino, Italy.

Our aim is evaluating the changes in weight and dietary habits in a sample of outpatients with obesity after 1 month of enforced lockdown during the COVID-19 pandemic in Northern Italy. In this observational retrospective study, the patients of our Obesity Unit were invited to answer to a 12-question multiple-choice questionnaire relative to weight changes, working activity, exercise, dietary habits, and conditions potentially impacting on nutritional choices. A multivariate regression analysis was performed to evaluate the associations among weight/BMI changes and the analyzed variables. A total of 150 subjects (91.5%) completed the questionnaire. Mean self-reported weight gain was ≈1.5 kg ( < 0.001). Lower exercise, self-reported boredom/solitude, anxiety/depression, enhanced eating, consumption of snacks, unhealthy foods, cereals, and sweets were correlated with a significantly higher weight gain. Multiple regression analyses showed that increased education (inversely, β = -1.15; 95%CI -2.13, -0.17, = 0.022), self-reported anxiety/depression (β = 1.61; 0.53, 2.69, = 0.004), and not consuming healthy foods (β = 1.48; 0.19, 2.77, = 0.026) were significantly associated with increased weight gain. The estimated direct effect of self-reported anxiety/depression on weight was 2.07 kg (1.07, 3.07, < 0.001). Individuals with obesity significantly gained weight 1 month after the beginning of the quarantine. The adverse mental burden linked to the COVID-19 pandemic was greatly associated with increased weight gain.
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http://dx.doi.org/10.3390/nu12072016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400808PMC
July 2020

Acute assessment of subjective appetite and implicated hormones after a hypnosis-induced hallucinated meal: a randomized cross-over pilot trial.

Rev Endocr Metab Disord 2020 Sep;21(3):411-420

Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Turin, Italy.

The use of hypnosis can generate hallucinatory phenomena, which ranged from vivid/auditory imagery to fully developed "hallucinations" in selected people. The aim of this pilot trial was investigating the acute effects of a hypnosis-induced hallucinated breakfast (HB) compared to those of a real breakfast (RB) on subjective appetite and appetite-regulating hormones in highly hypnotizable individuals. Eight healthy post-menopausal women were recruited to consume two meals: the HB and the RB in a randomized crossover design. Participants underwent appetite sensations measurements (before meal and each 30-min until 270-min) and blood sample collection (at 0, 20, 60, 90, 180-min). A 3-day food-record was filled after each meal. The adjusted repeated measures ANCOVA did not show any meal×time interactions on subjective appetite postprandially. As expected, significantly higher glucose (p < 0.001), insulin (p < 0.001), and lower free fatty acid (p < 0.001) concentrations were found after the RB, but not following HB. Furthermore, RB significantly increased postprandial levels of glucagon-like-peptide-1 and peptide-YY at 20, 60, 90 and 180-min, whereas acylated-ghrelin and leptin levels did not differ. Postprandial neuropeptide-Y and orexin-A values significantly increased at different time-points after RB, but not following HB, while α-melanocyte-stimulating hormone levels enhanced after HB only. Energy intakes were significantly lower after HB on the test-day only (HB = 1146.6 ± 343.8 vs RB = 1634.7 ± 274.2 kcal/d; p = 0.003). Appetite sensation might be modulated by fully developed meal "hallucination" induced by hypnosis, likely affecting brain-peptides implicated in the appetite regulation. However, further studies are needed to verify these results obtained in a highly selected group of individuals. NCT03934580.
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http://dx.doi.org/10.1007/s11154-020-09559-4DOI Listing
September 2020

Is HDL cholesterol protective in patients with type 2 diabetes? A retrospective population-based cohort study.

J Transl Med 2020 05 6;18(1):189. Epub 2020 May 6.

Department of Medical Sciences, University of Turin, Corso AM Dogliotti, 14 10126, Turin, To, Italy.

Background: The protective role of high HDL cholesterol levels against cardiovascular diseases has been recently questioned. Limited data are available on this specific topic in patients with type 2 diabetes mellitus (T2DM). We aimed to evaluate the association of HDL cholesterol concentrations with all-cause and cause-specific mortality in a historical cohort of T2DM patients with 14 years of follow-up.

Methods: This is a retrospective population-based cohort study involving 2113 T2DM patients attending the Diabetic Clinic of Asti. Survival analyses were performed to assess hazard ratios for overall and specific-cause mortality by HDL cholesterol tertiles, using the middle HDL cholesterol tertile as a reference.

Results: The mean age was 66 ± 11 years; 51.4% of patients had low HDL-cholesterol levels. After a 14-year follow-up, 973/2112 patients had died (46.1%). The HDL cholesterol tertile cut-off points were 37.5 and 47.5 mg/dL (males) and 41.5 and 52.0 mg/dL (females). No associations between lower and upper HDL cholesterol tertiles respectively and all-cause (HR = 1.12; 95% CI 0.96-1.32; HR = 1.11; 0.95-1.30), cardiovascular (HR = 0.97; 0.77-1.23; HR = 0.94; 0.75-1.18) or cancer (HR = 0.92; 0.67-1.25; HR = 0.89; 0.66-1.21) mortality were found. A significantly increased risk for infectious disease death was found both in the lower (HR = 2.62; 1.44-4.74) and the upper HDL-cholesterol tertiles (HR = 2.05; 1.09-3.85) when compared to the reference. Individuals in the upper tertile showed an increased risk for mortality due to diabetes-related causes (HR = 1.87; 1.10-3.15).

Conclusions: Our results corroborate the hypothesis that HDL cholesterol levels are nonprotective in T2DM patients. The U-shaped association between HDL-cholesterol levels and mortality associated with infectious diseases should be verified by further studies.
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http://dx.doi.org/10.1186/s12967-020-02357-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7203837PMC
May 2020

A Critical Review on the Role of Food and Nutrition in the Energy Balance.

Nutrients 2020 Apr 22;12(4). Epub 2020 Apr 22.

Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, 33100 Udine, Italy.

The mass media has increasingly frequently suggested to the general population that specific foods or nutritional schemes are able to affect both human metabolism and energy expenditure, thus facilitating weight loss. This critical review is aimed at assessing available evidence on the roles of nutrients, food and dietary regimens in energy intake and energy expenditure. We queried the National Library of Medicine, the Cochrane Library, Excerpta Medica dataBASEand the Cumulative Index to Nursing and Allied Health Literature database, and a search strategy was performed by using database-specific subject headings and keywords. We found that available scientific evidence on these topics is scarce, and that the limited number of available studies often have poor methodological quality. Only a few foods show beneficial effects on metabolism and energy expenditure, as the human energy balance is complex and multifactorial. Finally, microbiota may interfere with the intake, use and expenditure of energy in the human body. Conclusive evidence is still lacking, and, at present, it is not possible to identify a food or a diet with a significant impact on human energy expenditure.
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http://dx.doi.org/10.3390/nu12041161DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231187PMC
April 2020

Gut microbiota composition after diet and probiotics in overweight breast cancer survivors: a randomized open-label pilot intervention trial.

Nutrition 2020 06 29;74:110749. Epub 2020 Jan 29.

Department of Clinical Nutrition, Città della Salute e della Scienza, Turin, Italy. Electronic address:

Objectives: Breast cancer (BC) is the most diagnosed cancer in women. Increasing survival rates shift attention to preventive strategies. Obesity and intestinal microbiota composition may be associated with BC. A Mediterranean diet (MD) proved to be protective. The aim of this study was to assess the efficacy of probiotics in addition to an MD versus diet alone in influencing gut microbiota and metabolic profile in overweight BC survivors.

Methods: A total of 34 BC survivors were randomly assigned to an MD for 4 mo plus 1 sachet/d of probiotics (Bifidobacterium longum BB536, Lactobacillus rhamnosus HN001) for the first 2 mo (intervention group, n = 16) or an MD alone for 4 mo (control group, n = 18). Anthropometric and nutritional assessments, adherence to the MD, compliance with physical activity, and metabolic parameters dosage were performed at baseline (T0), at 2 mo (T2), and at 4 mo (T4). Intestinal microbiota analysis was performed at T0 and T2.

Results: After 2 mo of probiotic administration the number of bacterial species (P = 0.01) and the bacterial diversity assessed with the Chao1 index (P = 0.004) significantly increased; no significant variations were detected after diet alone. The Bacteroidetes-to-Firmicutes ratio significantly decreased in the intervention group and increased in controls (P = 0.004). Significant reductions of body weight, body mass index, fasting glucose, and homeostasis model assessment of insulin resistance were identified at T4 in both groups; in the intervention group waist circumference (P = 0.012), waist-to-hip ratio (P = 0.045), and fasting insulin (P = 0.017) also significantly decreased.

Conclusions: Probiotics in addition to an MD positively influence gut microbiota and improve metabolic and anthropometric parameters compared with an MD alone.
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http://dx.doi.org/10.1016/j.nut.2020.110749DOI Listing
June 2020

Correction to: Effects of time-restricted feeding on body weight and metabolism. A systematic review and meta-analysis.

Rev Endocr Metab Disord 2020 Mar;21(1):35

Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Turin, Italy.

The article "Effects of time-restricted feeding on body weight and metabolism. A systematic review and meta-analysis" written by Pellegrini Marianna, Cioffi Iolanda, Evangelista Andrea, Ponzo Valentina, Goitre Ilaria, Ciccone Giovannino, Ghigo Ezio, Bo Simona" was originally published with the surname and then first name of all authors.
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http://dx.doi.org/10.1007/s11154-020-09542-zDOI Listing
March 2020

Effects of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors on ageing: Molecular mechanisms.

Ageing Res Rev 2020 03 30;58:101024. Epub 2020 Jan 30.

Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address:

Human ageing is determined by degenerative alterations and processes with different manifestations such as gradual organ dysfunction, tissue function loss, increased population of aged (senescent) cells, incapability of maintaining homeostasis and reduced repair capacity, which collectively lead to an increased risk of diseases and death. The inhibitors of HMG-CoA reductase (statins) are the most widely used lipid-lowering agents, which can reduce cardiovascular morbidity and mortality. Accumulating evidence has documented several pleiotropic effects of statins in addition to their lipid-lowering properties. Recently, several studies have highlighted that statins may have the potential to delay the ageing process and inhibit the onset of senescence. In this review, we focused on the anti-ageing mechanisms of statin drugs and their effects on cardiovascular and non-cardiovascular diseases.
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http://dx.doi.org/10.1016/j.arr.2020.101024DOI Listing
March 2020

The microbiota composition of the offspring of patients with gestational diabetes mellitus (GDM).

PLoS One 2019 16;14(12):e0226545. Epub 2019 Dec 16.

Department of Medical Sciences, University of Turin, Turin, Italy.

The microbiota composition of the offspring of women with gestational diabetes mellitus (GDM), a common pregnancy complication, is still little known. We investigated whether the GDM offspring gut microbiota composition is associated with the maternal nutritional habits, metabolic variables or pregnancy outcomes. Furthermore, we compared the GDM offspring microbiota to the microbiota of normoglycemic-mother offspring. Fecal samples of 29 GDM infants were collected during the first week of life and assessed by 16S amplicon-based sequencing. The offspring's microbiota showed significantly lower α-diversity than the corresponding mothers. Earlier maternal nutritional habits were more strongly associated with the offspring microbiota (maternal oligosaccharide positively with infant Ruminococcus, maternal saturated fat intake inversely with infant Rikenellaceae and Ruminococcus) than last-trimester maternal habits. Principal coordinate analysis showed a separation of the infant microbiota according to the type of feeding (breastfeeding vs formula-feeding), displaying in breast-fed infants a higher abundance of Bifidobacterium. A few Bacteroides and Blautia oligotypes were shared by the GDM mothers and their offspring, suggesting a maternal microbial imprinting. Finally, GDM infants showed higher relative abundance of pro-inflammatory taxa than infants from healthy women. In conclusion, many maternal conditions impact on the microbiota composition of GDM offspring whose microbiota showed increased abundance of pro-inflammatory taxa.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0226545PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913919PMC
April 2020

Effects of time-restricted feeding on body weight and metabolism. A systematic review and meta-analysis.

Rev Endocr Metab Disord 2020 03;21(1):17-33

Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Turin, Italy.

Restriction in meal timing has emerged as a promising dietary approach for the management of obesity and dysmetabolic diseases. The present systematic review and meta-analysis summarized the most recent evidence on the effect of time-restricted feeding (TRF) on weight-loss and cardiometabolic variables in comparison with unrestricted-time regimens. Studies involving TRF regimen were systematically searched up to January 2019. Effect size was expressed as weighted mean difference (WMD) and 95% confidence intervals (CI). A total of 11 studies, 5 randomized controlled trials and 6 observational, were included. All selected studies had a control group without time restriction; hours of fasting ranged from 12-h until 20-h and study duration from 4 to 8-weeks. Most studies involved the Ramadan fasting. TRF determined a greater weight-loss than control regimens (11 studies, n = 485 subjects) (WMD: -1.07 kg, 95%CI: -1.74 to -0.40; p = 0.002; I = 56.2%), unrelated to study design. The subgroup analysis showed an inverse association between TRF and fat free mass in observational studies (WMD: -1.33 kg, 95%CI: -2.55 to -0.11; p = 0.03; I = 0%). An overall significant reduction in fasting glucose concentrations was observed with TRF regimens (7 studies, n = 363 subjects) (WMD: -1.71 mg/dL, 95%CI: -3.20 to -0.21; p = 0.03; I = 0%), above all in trials (WMD:-2.45 mg/dL, 95%CI: -4.72 to -0.17; p = 0.03; I = 0%). No between-group differences in the other variables were found. TRF regimens achieved a superior effect in promoting weight-loss and reducing fasting glucose compared to approaches with unrestricted time in meal consumption. However, long-term and well-designed trials are needed to draw definitive conclusions.
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http://dx.doi.org/10.1007/s11154-019-09524-wDOI Listing
March 2020

Traits of orthorexia nervosa and muscle dysmorphia in Italian university students: a multicentre study.

Eat Weight Disord 2020 Oct 17;25(5):1413-1423. Epub 2019 Sep 17.

Department of Public Health and Pediatrics, University of Turin, Via Santena 5bis, 10126, Turin, Italy.

Purpose: This study aimed to evaluate the prevalence of traits of orthorexia nervosa (ON) and muscle dysmorphia (MD) in a group of undergraduates, investigate the associations between the risk of these conditions and the type of university course attended, the individual characteristics (gender, BMI, amount of physical activity, supplements and medicines use, dieting) and the risk of eating disorders (EDs).

Methods: A self-reported questionnaire consisting of a socio-demographic section and three tests validated for the evaluation of a risk of ON (ORTO-15), MD (MDDI-ITA) and EDs (EAT-26) was completed by 918 students from three Italian universities.

Results: 29.0% of participants demonstrated traits of ON and 5.0% of MD, without differences in prevalence in the three areas of study investigated (health-scientific, economic-humanistic, sport sciences); students of sport sciences exhibited a significantly higher score for MDDI-ITA (F = 6.493, p = 0.002). Participants with ON and MD traits were more on a diet (OR = 0.47, p ≤ 0.001 and OR = 0.428, p = 0.020, respectively) and showed a higher prevalence of EDs risk (OR = 3.55, p < 0.001 and OR = 10.23, p ≤ 0.001, respectively). The simultaneous presence of ON, MD, and EDs traits was seen in 5.4% of the students and the three test scores were correlated.

Conclusions: The prevalence of ON and MD traits was found similar to that reported in the literature on undergraduates. Some associations observed improvement in the knowledge about these conditions, especially the association of participants with ON and MD traits with dieting and EDs traits and the correlation of the three test scores suggests a connection among these potential conditions.

Level Of Evidence: Level V, descriptive cross-sectional survey.
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http://dx.doi.org/10.1007/s40519-019-00779-5DOI Listing
October 2020

Modulation of microRNAs by aspirin in cardiovascular disease.

Trends Cardiovasc Med 2020 07 14;30(5):249-254. Epub 2019 Aug 14.

Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address:

Aspirin is among the most widely prescribed drugs in cardiovascular and cerebrovascular diseases for both primary and secondary prevention. The major mechanisms underlying its benefits are the inhibitory effects on platelet activation and prostanoid biosynthesis induced by COX-1 and COX-2 inactivation. MicroRNAs (miRNAs) are newly proposed mediators of the effects of aspirin. In this review, we summarize the evidence on the links between miRNAs and aspirin use in relation to cardiovascular diseases. In addition, we discuss the studies suggesting a possible role for miRNAs as biomarkers of aspirin resistance, a condition during which atherothrombotic events occur despite aspirin use, and which affects a considerable proportion of patients with cardiovascular disease.
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http://dx.doi.org/10.1016/j.tcm.2019.08.005DOI Listing
July 2020

Resolvins: Emerging Players in Autoimmune and Inflammatory Diseases.

Clin Rev Allergy Immunol 2020 Feb;58(1):82-91

Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Resolvins, belonging to the group of specialized proresolving mediators (SPMs), are metabolic products of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) and are synthesized during the initial phases of acute inflammatory responses to promote the resolution of inflammation. Resolvins are produced for termination of neutrophil infiltration, stimulation of the clearance of apoptotic cells by macrophages, and promotion of tissue remodeling and homeostasis. Metabolic dysregulation due to either uncontrolled activity of pro-inflammatory responses or to inefficient resolution of inflammation results in chronic inflammation and may also lead to atherosclerosis or other chronic autoimmune diseases such as rheumatoid arthritis, psoriasis, systemic lupus erythematosus, vasculitis, inflammatory bowel diseases, and type 1 diabetes mellitus. The pathogenesis of such diseases involves a complex interplay between the immune system and, environmental factors (non-infectious or infectious), and critically depends on individual susceptibility to such factors. In the present review, resolvins and their roles in the resolution of inflammation, as well as the role of these mediators as potential therapeutic agents to counteract specific chronic autoimmune and inflammatory diseases are discussed.
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http://dx.doi.org/10.1007/s12016-019-08754-9DOI Listing
February 2020

Diet-Gut Microbiota Interactions and Gestational Diabetes Mellitus (GDM).

Nutrients 2019 Feb 3;11(2). Epub 2019 Feb 3.

Department of Medical Sciences, University of Turin, 10126 Turin, Italy.

Medical nutritional therapy is the first-line approach in managing gestational diabetes mellitus (GDM). Diet is also a powerful modulator of the gut microbiota, whose impact on insulin resistance and the inflammatory response in the host are well known. Changes in the gut microbiota composition have been described in pregnancies either before the onset of GDM or after its diagnosis. The possible modulation of the gut microbiota by dietary interventions in pregnancy is a topic of emerging interest, in consideration of the potential effects on maternal and consequently neonatal health. To date, very few data from observational studies are available about the associations between diet and the gut microbiota in pregnancy complicated by GDM. In this review, we analyzed the available data and discussed the current knowledge about diet manipulation in order to shape the gut microbiota in pregnancy.
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http://dx.doi.org/10.3390/nu11020330DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6413040PMC
February 2019

Intermittent versus continuous energy restriction on weight loss and cardiometabolic outcomes: a systematic review and meta-analysis of randomized controlled trials.

J Transl Med 2018 12 24;16(1):371. Epub 2018 Dec 24.

Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Turin, Italy.

Background: This systematic review and meta-analysis summarized the most recent evidence on the efficacy of intermittent energy restriction (IER) versus continuous energy restriction on weight-loss, body composition, blood pressure and other cardiometabolic risk factors.

Methods: Randomized controlled trials were systematically searched from MEDLINE, Cochrane Library, TRIP databases, EMBASE and CINAHL until May 2018. Effect sizes were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI).

Results: Eleven trials were included (duration range 8-24 weeks). All selected intermittent regimens provided ≤ 25% of daily energy needs on "fast" days but differed for type of regimen (5:2 or other regimens) and/or dietary instructions given on the "feed" days (ad libitum energy versus balanced energy consumption). The intermittent approach determined a comparable weight-loss (WMD: - 0.61 kg; 95% CI - 1.70 to 0.47; p = 0.87) or percent weight loss (WMD: - 0.38%, - 1.16 to 0.40; p = 0.34) when compared to the continuous approach. A slight reduction in fasting insulin concentrations was evident with IER regimens (WMD = - 0.89 µU/mL; - 1.56 to - 0.22; p = 0.009), but the clinical relevance of this result is uncertain. No between-arms differences in the other variables were found.

Conclusions: Both intermittent and continuous energy restriction achieved a comparable effect in promoting weight-loss and metabolic improvements. Long-term trials are needed to draw definitive conclusions.
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http://dx.doi.org/10.1186/s12967-018-1748-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304782PMC
December 2018

Correction to: Clinical impact of hospital malnutrition.

Intern Emerg Med 2019 01;14(1):193

Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Turin, Italy.

In the original publication, article was published with a wrong title as 'Risk, prevalence, and impact of hospital malnutrition in a Tertiary Care Referral University Hospital: a cross-sectional study' and also one of the references has been omitted in the reference list. The correct article title should be read as 'Clinical impact of hospital malnutrition'.
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http://dx.doi.org/10.1007/s11739-018-2006-8DOI Listing
January 2019

Clinical impact of hospital malnutrition.

Intern Emerg Med 2019 01 24;14(1):7-9. Epub 2018 Nov 24.

Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Turin, Italy.

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http://dx.doi.org/10.1007/s11739-018-1987-7DOI Listing
January 2019
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