Publications by authors named "Amelia Brunani"

: Whole-body cryostimulation (WBC) involves exposure to extremely low temperatures to reduce inflammation and pain and to enhance recovery. Despite its growing popularity and the importance of the magnitude of WBC-induced skin cooling in triggering the cascade of effects, limited research has focused on skin temperature changes in individuals with severe obesity, where body composition and sex may influence outcomes. : To examine differences in the cooling response based on sex and BMI, we conducted an observational study comparing patients with obesity to normal-weight individuals after repeated WBC sessions.

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Article Synopsis
  • Obesity is closely tied to metabolic issues that lead to serious health risks, prompting a call for unified efforts from medical professionals and policymakers to promote healthy lifestyles and prevent obesity rather than treating it separately.
  • A thorough search of published articles focused solely on obesity prevention was conducted, gathering data from various reputable sources such as academic databases and health agency websites.
  • A comprehensive approach to obesity prevention is essential, necessitating collaboration among individuals, communities, and healthcare systems to create a supportive environment for healthier choices while addressing the need for clear national and international guidelines.
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  • * A study involving 2004 hospitalized patients with obesity evaluated a 4-week multidisciplinary weight-loss intervention, revealing that 42.55% of initial SO patients improved their handgrip strength (HGS) and no longer met SO criteria at discharge.
  • * The findings highlight that increases in HGS and phase angle (PhA) are important indicators of successful weight-loss interventions in SO patients, suggesting that focused strategies on these measures can help improve outcomes for this population.
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Recent evidence suggests that whole-body cryostimulation (WBC) may be beneficial for patients with fibromyalgia (FM), but little is known about the duration of such effects. The purpose of this study was to verify the duration of clinical-functional benefits after one cycle of WBC. We conducted a follow-up study on the medium and long-term effects of WBC on well-being, use of pain-relieving/anti-inflammatory medications, pain level, fatigue, sleep quality, and psychological aspects such as mood and anxiety.

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BACKGROUND Preliminary data suggest an adipogenic role for growth arrest-specific 6 (Gas6), a pleiotropic molecule involved in inflammation, proliferation, and hemostasis through its Tyro3, Axl, and MerTK (TAM) receptors. This study compares Gas6 expression in plasma and visceral and subcutaneous adipose tissue in 42 adults with obesity (body mass index ≥40 kg/m²) and 32 normal-weight controls to elucidate its role in obesity and related metabolic alterations. MATERIAL AND METHODS Using a case-control design, we measured Gas6 levels in plasma via a validated sandwich enzyme-linked immunosorbent assay and in adipose tissues through quantitative polymerase chain reactio with specific probes.

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: Sarcopenic obesity (SO) is the combination of excess fat, skeletal muscle and muscular strength/function deficit. The ESPEN/EASO have proposed new diagnostic criteria, but the SO prevalence in patients with severe obesity remains to be established. The aim of this study was to establish the SO prevalence in a large cohort of inpatients with obesity, considering sex, age, BMI, type, and number of concomitant diseases.

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Article Synopsis
  • - A study focused on patients with obesity experiencing post-COVID symptoms demonstrated that understanding their condition is crucial for tailored rehabilitation approaches due to significant health and socioeconomic impacts.
  • - Sixteen patients underwent a four-week rehabilitation program combining exercises, nutrition, psychological support, and whole-body cryostimulation (WBC), leading to notable improvements in weight, body measurements, lipid levels, and psychological well-being.
  • - The findings indicate that this multidisciplinary approach, including WBC, is both safe and effective in enhancing health outcomes for post-COVID patients with obesity, suggesting WBC could be a valuable addition to rehabilitation programs.
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Adults with obesity have a higher risk of hospitalization and high hospitalization-related healthcare costs. However, a predictive model for the risk of readmission in patients with severe obesity is lacking. We conducted a retrospective cohort study enrolling all patients admitted for severe obesity (BMI ≥ 40 kg/m) between 2009 and 2018 to the Istituto Auxologico Italiano in Piancavallo.

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  • Weight loss can lead to a reduction in muscle mass, affecting strength and function, especially in middle-aged men with severe obesity (BMI > 35 kg/m).
  • A study with 40 male participants tested the effects of various supplements (control, protein, branched-chain amino acids, and a specific essential amino acid blend) during a low-calorie diet and exercise program.
  • Results showed significant muscle mass gain in the group receiving the essential amino acid blend (PD-E07), while the other supplement groups did not show meaningful differences compared to the control group; more research is needed to confirm these findings.
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Phase angle (PhA) is a recently proposed marker of nutritional status in many clinical conditions. Its use in patients with obesity presents different critical concerns due to the higher variability of the two measured parameters (resistance, R, and reactance, Xc) that contribute to the determination of PhA. Controversial is the relation between PhA and BMI that might vary with graded levels of obesity due to the variation in fat and free fat mass.

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Background: Telomere length (TL) and mitochondrial DNA (mtDNA) copy number shifts are linked to metabolic abnormalities, and possible modifications by diet-induced weight loss are poorly explored. We investigated the variations before (T0) and after a 1-year (T12) lifestyle intervention (diet + physical activity) in a group of outpatients with obesity. Methods: Patients aged 25−70 years with BMI ≥ 30 kg/m2 were enrolled.

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The relationship between skeletal muscle mass at the beginning of the post-acute rehabilitation phase and rehabilitation outcomes has been scarcely investigated. The aim of this study was to investigate the impact of the existence of sarcopenia upon admission to a post-acute COVID-19 patient rehabilitation unit on body composition and functional and respiratory capacity at discharge. Thirty-four post-acute COVID-19 patients were referred to our Rehabilitation Unit from different COVID Hospitals in northern Italy.

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Bariatric surgery (BS) confers a survival benefit in specific subsets of patients with severe obesity; otherwise, effects on hospital admissions are still uncertain. We assessed the long-term effect on mortality and on hospitalization of BS in patients with severe obesity. This was a retrospective cohort study, including all patients residing in Piedmont (age 18-60 years, BMI ≥ 40 kg/m) admitted during 2002-2018 to the Istituto Auxologico Italiano.

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Background & Aims: Obesity is characterized by fat mass excess (FM), extra cellular water increase (ECW) and, with ageing, decrease in fat free mass (FFM). The validity of body impedance analysis (BIA) in patients with mild to severe obesity is still debated. The purpose of this study is to describe the Resistance (Rz) and Reactance (Xc) values obtained by Body Impedance Analysis (BIA) in a wide cohort of Italian patients with mild to severe obesity.

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Introduction: Obesity is a condition that generally limits work capacity and predisposes to a number of comorbidities and related diseases, the last being COVID-19 and its complications and sequelae. Physical exercise, together with diet, is a milestone in its management and rehabilitation, although there is still a debate on intensity and duration of training. Anaerobic threshold (AT) is a broad term often used either as ventilatory threshold or as lactate threshold, respectively, detected by respiratory ventilation and/or respiratory gases (VCO and VO), and by blood lactic acid.

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Background: The COVID-19 pandemic is spreading all over the world, particularly in developed countries where obesity is also widespread. There is a high frequency of increased BMI in patients admitted to intensive care for SARS-CoV-2 infection with a major severity in patients with an excess of visceral adiposity. Patients at risk of severe SARS-CoV-2 acute respiratory syndrome are characterised by the high prevalence of pre-existing diseases (high blood pressure and cardiovascular disease, diabetes, chronic respiratory disease, or cancer), most of them typically present in severely obese patients.

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Background: Obesity is a clinical condition that contributes to the development of related disability in different areas (physical, psychological and social). Multidisciplinary treatment calls for specific instruments able to evaluate all related functional problems. We have developed a tool (an ICF-based assessment instrument, the ICF-OB schedule) to evaluate obesity-related disability, composed of an inventory of 71-items from the WHO International Classification of Functioning, Disability and Health (ICF).

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Background: The World Health Organization (WHO) has declared obesity as the largest global chronic health problem in adults. In the last years, attention has been drawn to rehabilitative interventions for patients with obesity.

Aim: The aim of this manuscript is to provide Physical and Rehabilitation Medicine (PRM) physicians with evidence-based recommendations for the rehabilitation of patients with overweight or obesity and related comorbidities.

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Purpose: To allocate obese patients to the correct therapeutic setting, the Italian Obesity Society (SIO) has suggested a new algorithm based on the Edmonton obesity staging system (EOSS). The aim of our study was to apply in two retrospective cohorts of obese patients both the EOSS and the activities of daily life (ADL) scale to identify also their rehabilitation needs.

Methods: 288 out-patients and 298 in-patients were recruited.

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The treatment of obesity requires creating an energy deficit through caloric restriction and physical activity. Energy needs are estimated assessing the resting energy expenditure (REE) that in the clinical practice is estimated using predictive equations. In the present cross sectional study, we compared, in a large cohort of morbidly obese patients, the accuracy of REE predictive equations recommended by current obesity guidelines [Harris-Benedict, WHO/FAO/ONU and Mifflin-St Jeor (MJ)] and/or developed for obese patients (Muller, Muller BC, Lazzer, Lazzer BC), focusing on the effect of comorbidities on the accuracy of the equations.

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Objective: The metabolic syndrome (MS) is a multifactorial disorder associated with a higher risk of developing cardiovascular diseases and type 2 diabetes. However, its pathophysiology and risk factors are still poorly understood. In this study, we investigated the associations among gender, psychosocial variables, job-related stress and the presence of MS in a cohort of obese Caucasian workers.

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Article Synopsis
  • The text discusses how the context of medical encounters, especially the placebo effect, can influence treatment outcomes in neurorehabilitation.
  • A review of studies reveals that placebo treatments show varying levels of effectiveness for different neurological disorders, with weak effects in central neuropathic pain and moderate effects in conditions like postherpetic neuralgia and diabetic peripheral neuropathy.
  • The findings suggest that understanding and utilizing the placebo effect can enhance neurorehabilitation programs, improve the doctor-patient relationship, and reduce reliance on analgesics, without needing to hide the use of placebos from patients.
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