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Given the high levels of inactivity and sedentary lifestyle in the general population and the barriers (including motivational ones) to the practice of regular physical activity, our study aims to evaluate the physical activity levels (PAL), sitting time (SIT), and motivation to change (MTC) lifestyle in a group of volunteer adults participating in an online survey promoted in some Italian regions. From December 2022 to March 2023, 127 adults (65 men and 62 women, mean age=40.17±14.83 years), volunteers, were involved in this study. Participants were invited to complete one-time online survey. General information, anthropometric, and questionnaire measures were collected. According to inclusion criteria, four participants were excluded; here we present results for 123 subjects. Data were studied for active/inactive and gender subgroups. Finally, the PAL and SIT categories were linked to motivational data. 54.8% of the participants did not report particular pathologies. 52.8% of participants replied that they regularly exercised. 44.4% engaged in physical activity alone, while 27% did so with friends, and 23.8% with a kinesiologist. Differences were observed both in the energy expenditure due to vigorous PA and in total energy expenditure. Regarding SIT, there were no differences between genders during weekdays. All the sample presented a high percentage in contemplation status but had medium scores in preparation and maintenance status. A statistically significant difference was observed in the contemplation state: we found higher average values regarding self-efficacy and readiness to change in men. It is necessary to plan campaigns to raise awareness and monitor the population's lifestyles beginning in the first decades of adulthood, promoting healthy lifestyle education initiatives to control the risk of non-communicable diseases. [ABSTRACT FROM AUTHOR]

Introduction: Exercise training improves walking capacity in patients with intermittent claudication (IC). Endothelial progenitor cells (EPCs), endothelial microparticles (EMPs), and endothelial dysfunction could play a role in this process. Methods: We measured EPCs and EMPs in a group of 60 patients with IC, and in a control group of 20 individuals without IC, before a treadmill test and 2, 24, and 48 hours after the test. Thirty patients with IC were randomly assigned to perform a 12-week home-based exercise training program. The EPC count, flow-mediated dilation (FMD) of the brachial artery, pain-free walking time (PFWT), and maximum walking time (MWT) were measured at the baseline and after the exercise training program. Results: In patients with IC, EMPs significantly increased 2 hours after the treadmill test, whereas EPCs significantly increased after 24 hours. Among the subjects assigned to complete the training program, we observed a significant increase in the number of EPCs after 12 weeks, as well as an improvement in FMD, PFWT, and MWT. A significant correlation between the variation of EPCs, FMD, and MWT was found. The increase of EPCs and FMD were independent determinants of the walking capacity improvement, without significant interaction. Conclusion: Our results suggest that EPCs mobilization contributes to the improvement of walking capacity in patients with IC undergoing structured physical training. A number of different, partly independent, mechanisms are involved in this process, and our results highlight the potential role of EMPs release and endothelial function improvement. ClinicalTrials.gov Identifier: NCT04302571 [ABSTRACT FROM AUTHOR]

Introduction Prosthetic joint infections are severe complications of joint implants. Further complications arise when polymicrobial and/or multidrug-resistant microorganisms are involved. Currently, there are limited data on the management of these infections and on the tolerability of long-term treatment with daptomycin, ceftazidime and colistin. Case presentation A 55-year-old Caucasian woman who had a right hip prosthesis removed 1 year prior because of infection was admitted for prosthesis reimplantation. On admission at our hospital, anamnesis regarding etiology and management of prosthesis infection was not available. On clinical, laboratory findings and imaging studies infection was not suspected. A hip prosthesis was reimplanted. At surgery, histopathological and microbiological investigations were not taken. Three weeks after reimplantation, surgical site infection due to Enterobacter cloacae was diagnosed and oral ciprofloxacin was prescribed. Four days later, a periprosthesis fluid collection was evidenced and a percutaneous needle aspirate grew Staphylococcus epidermidis and S. haemolyticus. Enterobacter genome was also detected from the same sample. Teicoplanin and meropenem were added to ciprofloxacin without clinical improvement. Moreover, acetabular cup dislocation was documented. She underwent prosthesis explantation, debridement, and positioning of an antimicrobial mixed spacer. From the intraoperatory cultures S. epidermidis and Acinetobacter baumannii were grown. Daptomycin, ceftazidime, colistin and rifampin were administered. Four days later, rifampin was stopped due to a suspected liver toxicity. While undergoing therapy she presented recurrent episodes of wound dehiscence and on the 22nd week of treatment a further surgical debridement was performed, upon which the spacer was removed. At this time, intraoperative cultures resulted negative. Three months later, after a total of 8 months, antimicrobials were interrupted. Subsequently, a femoral transcondylar traction was positioned, and 3 weeks later a new prosthesis was reimplanted. At over 1 year after reimplantation she is well. Conclusions Our findings suggest that microbiologic investigations are mandatory even when prosthetic joint is not suspected. Molecular methods for identification of microorganisms can be used in addition to conventional cultures especially when patients are under antibiotic treatment. Daptomycin, ceftazidime and colistin can be administered for several months without side effects. Guidelines specifically addressing the diagnosis and the management of polymicrobial, multidrug-resistant prosthetic joint infections need to be developed. [ABSTRACT FROM AUTHOR]

Abstract: Background: Peripheral arterial disease (PAD) is frequently underdiagnosed in the clinical practice, leading to a lack of opportunity to detect subjects at a high risk for cardiovascular (CV) death. The ankle-brachial pressure index (ABI) represents a noninvasive, objective tool to diagnose PAD and to predict adverse outcome. Methods: ABI was determined by means of Doppler velocimetry, in 707 patients, aged 50years or older, consecutively hospitalized in an internal medicine ward, who were followed-up for at least 12months in order to assess all-cause and CV mortality. Results: Symptomatic PAD affected 8% of the population while the prevalence of PAD, defined as ABI <0.90, was 29%; high ABI (>1.40) was found in 8% of the patients. After a mean follow-up period of 1.6years, both low and high ABI were independently associated with CV mortality with a hazard ratio of 1.99 (p=0.016) for low and 2.13 (p=0.04) for high ABI, compared with normal ABI (0.90–1.40). High ABI also independently predicted all-cause mortality with a hazard ratio of 1.77 (p=0.04). Discussion: ABI measurement reveals a large number of individuals with asymptomatic PAD among those hospitalized in an internal medicine department. An increased mortality was observed in patients with both low and high ABI. Hospital admission for any reason may serve as an opportunity to detect PAD and start appropriate preventive actions. [Copyright &y& Elsevier]

Determines whether critical leg ischemia (CLI) is an independent risk factor for all-cause and cardiovascular mortality, paying attention to the confounding effect of other prognostic factors. Reliability of chronic CLI as an independent predictor of overall and cardiovascular mortality; Comparison of the predictive values of the presence of critical ischemia and a low ankle-brachial blood pressure index.

Raynaud's phenomenon is in most cases idiopathic, but it may appear as secondary to other diseases. Since clinical evaluation is often inadequate to distinguish between these two forms, simple noninvasive methods are needed for an early diagnosis of the secondary form. The authors used nailfold capillaroscopy to study 58 patients with Raynaud's phenomenon—44 apparently idiopathic and 14 secondary to connective tissue diseases. In all patients affected by secondary Raynaud's phenomenon nailfold capillaroscopy confirmed the presence of an abnormal pattern with typical systemic sclerosis alterations in 5 cases. Twenty-one (48%) of the other 44 patients presented a normal capillaroscopic pattern, 15 (34%) had alterations compatible with long-term idiopathic Raynaud's phenomenon, and 8 (18%) showed abnormal capillaroscopic patterns, 2 of which were identified as the sclerodermic pattern. Nailfold capillaroscopy distinguishes between primary and secondary Raynaud's phenomenon and may be used to identify patients presenting no evidence of underlying disease who could be at risk of developing connective tissue disease. [ABSTRACT FROM AUTHOR]

The efficacy of physical training alone or combined with antiplatelet therapy (dipyridamole and aspirin) was studied in 30 patients with stage II peripheral arterial occlusive disease (PAOD). Patients were randomly allocated to one of the following groups: Group A-dipyridamole 75 mg three times daily and aspirin 330 mg once daily: Group B- physical exercise; Group C-physical exercise and dipyridamole 75 mg three time daily and aspirin 330 mg once daily. After six months' treatment the pain-free walking time (PFWT) and the maximum walking time (MWT) improved significantly (p<0.05) in all three groups. In group A the PFWT lengthened by 35% (from 101.00 ± 34.56 to 137.32 ± 40.50 s) and the MWT by 38% (from 150.34 ± 55.60 to 207.26 ± 60.67 s); in group B the PFWT lengthened by 90% (from 90.65±40.54 to 171.45 ±55.60 s) and the MWT by 86% (from 145.39 ±60.50 to 270.63 ±63.61 s). When physical exercise was associated with drugs as in group C, the PFWT lengthened by 120% (from 89.51 ±43.89 to 196.72±51.73 s) and the MWT by 105% (from 160.43 ±59.84 to 329.05 ±63.96 s). No significant variations were observed at any stage of the study in the ankle/arm pressure ratio at rest and after standard treadmill exercise, in the plethysmographic rest and peak flows, or in the transcutaneous oxygen pressure in basal conditions and in its half recovery time after an induced ischemia. The results confirm the benefits of regular exercise in stage II PAOD patients but suggest they may be enhanced by antiplatelet therapy. [ABSTRACT FROM AUTHOR]

Whole blood filterability was monitored in 16 nondiabetic peripheral vascular disease (PVD) patients within forty-eight hours of onset of bacterial infection, after ten to seventeen days antibiotic therapy and again, ten days later, after convalescence. The whole blood filterability rate was constantly disturbed before infection in these patients; the impairment worsened significantly (as was expected during infection), but after convalescence the whole blood filterability rate did not return to preinfection levels. This further significant impairment in whole blood filterability was inversely correlated with a reduction in the patients' pain-free walking time as determined by a standard treadmell test performed after convalescence and compared with their average times before infection. [ABSTRACT FROM AUTHOR]

Treating chronic arterial occlusive disease with heparin is controversial because of the risks associated with long-term anticoagulant therapy. Low molecular weight (LMW) heparin (mw about 5000 Dalton), which selectively inhibits the Xa factor with minimal risk of hemorrhage, seems to offer new possibilities in the prevention and treatment of both venous and acute arterial thromboembolism. Therefore, 44 patients with intermittent claudication were recruited to a randomized, double-blind, controlled study. Twenty-two were treated for six months with a single daily subcutaneous dose (15,000 UaXa) of LMW heparin and 22 with placebo administered in the same way over the same period of time. After six months, LMW heparin treatment not only improved walking capacity (by lengthening the pain-free walking time by 25%) but also significantly modified the hemorrheologic pattern (by reducing fibrinogen concentrations and whole blood viscosity at low shear rates). LMW heparin also exerted an antithrombotic and profibrinolytic effect by significantly increasing both the anti-Xa factor and plasminogen activity without markedly modifying activated partial thromboplastin time (+ 20%). No LMW heparin-treated patient hemorrhaged or reported other noteworthy side effects. These results suggest LMW heparin might be a useful drug in the long-term treatment of chronic arterial occlusive disease of the limbs. [ABSTRACT FROM AUTHOR]

The effects of 3-glucosaminoglycan sulfate on lipids and the hemorheologic parameters were observed in a preliminary double-blind crossover study in 30 hyperlipidemic peripheral vascular disease (PYD) patients. Parenteral administration of the test drug was associated with a reduction in serum lipids, especially in triglyceride levels, and a lowering of fibrinogen, plasma viscosity, and whole blood viscosity levels. These effects justify the drug's use in the treatment of PYD, especially when associated with hypertriglyceridemia and hemorheologic disturbances. [ABSTRACT FROM AUTHOR]

The effects of physical exercise on 8 stage II peripheral vascular disease (PVD) patients were observed after a six-month training program. Doppler velocimetry (including the treadmill test), strain gauge plethysmography, and transcutaneous oxygen pressure were used to quantify the results, which were compared with those obtained in a control group of another 8 stage n PVD patients, under placebo therapy for six months. The results show physical exercise increased the walking capacity, both the pain-free walking time and the maximum walking time. No significant difference was observed in the other parameters studied, in either the exercise patients or the control group. [ABSTRACT FROM AUTHOR]

The relationship between peripheral vascular disease (PVD) and plasma apoproteins has still not been well defined. The lipid and apoprotein pattern of a group of 20 normolipemic patients affected by peripheral vascular disease has been compared with 20 healthy normolipemic subjects. Mean triglyceride plasma levels were higher in normolipemic patients than in the healthy controls (107.8±31.5 mg% vs 73.3±28.6 mg%; p<0.03) while mean HDL-cholesterol values were significantly lower (36.5±5.4 mg% vs 44.4±7.1 mg%; p< 0.003). No significant difference was observed between the two groups in the mean values of the apoproteins AI (112.1±41.2 mg% in PVD vs 117.2±17.7 mg% in controls), AII (45.1±12.2 mg% vs 50.1±11.1 mg%), B (93.7±23.5 mg% vs 91.3±21.6 mg%), CII (3.9±2.6 mg% vs 2.6±1.7 mg%), c m (6.7±1.5 vs 5.9±1.4 mg%) and E (3.09±1.4 mg% vs 3.3±0.9 mg%). On the contrary the mean triglyceride/Apo-E ratio was higher in PVD patients than in the controls (52.3±42 vs 23.3±10; p<0.03). [ABSTRACT FROM AUTHOR]

The practical utility of transcutaneous oxygen tension (TcPO2) has been evaluated in 22 normal subjects and in 54 patients suffering from peripheral vascular disease (PVD) at various stages (II, III, IV), to define its clinical use in the diagnosis of PVD. Basal TcPO2 values can distinguish normal subjects only from stages m and IV PVD patients. In the case of stage n PVD patients the evaluation of the half-recovery time of TcPO2 basal values after an induced ischemia of the limb is mandatory. The study also showed that there are no significant statistical correlations among the TcPO2 values, Doppler, and plethysmographic parameters. [ABSTRACT FROM AUTHOR]

Abstract: Background: Many adults are not at recommended lipid levels and the extent of treatment of dyslipidemia remains poor. We investigated the burden of cardiovascular risk and the distance of lipid fractions from the recommended targets by statin therapy and risk status in patients referred to a tertiary care lipid clinic. Methods: Assessment of cardiovascular risk factors was performed in 1657 patients, mostly dyslipidemics, referred by family physicians to our Lipid Clinic, 393 patients being under statin therapy. The shortfall of lipid fractions from the National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP-III) recommended goals was evaluated. Results: A high prevalence of cardiovascular risk factors was found. LDL cholesterol target was reached by 20% and 45% of untreated and statin treated patients, whereas non-HDL cholesterol target by 13% and 45% of untreated and statin treated patients, respectively. LDL cholesterol was over the goal by 27% in untreated patients and by 25% in statin treated patients. More than 40% and 65% statin treated patients were taking either a low statin dose or statins with low-to-moderate LDL cholesterol lowering efficacy (<30%). A decrease in the proportion of patients at target and greater shortfalls from recommended goals were found from low to high risk categories. Conclusion: The shortfall in reaching lipid targets, particularly among high risk statin untreated patients, may be partly explained by delayed or even inadequate lipid lowering therapy. Shortfalls in reaching the targets are not necessarily high and might be possibly managed at a primary care level. [Copyright &y& Elsevier]

Investigates postprandial changes in flow-mediated vasolidation of the brachial artery in young healthy women free from cardiovascular risk factors. Measurement of total cholesterol, triglycerides and high-density lipoprotein cholesterol; Magnitude of postprandial triglyceride.