Patterns and Correlates of Grip Strength in Older Americans.
Curr Aging Sci. 2017 Nov 16;:
Authors: Forrest K, Williams A, Leeds M, Robare J, Bechard T
BACKGROUND: Muscle strength is a sensitive indicator of morbidity and mortality in older adults. Loss of muscle strength contributes to a decline in physical functioning. Hand grip strength is a simple measurement but correlated with total body muscle strength. This study evaluated the patterns and correlates of grip strength among older adults in the United States.
METHODS: The grip strength data were analyzed from the National Health and Nutrition Examination Survey.
RESULTS: Individuals (n=1009) aged ≥65 years old who had a grip strength measure were included in this analysis. Age distribution was 31.5%, 27.2%, 16.2%, and 25.0% for 65-69, 70-74, 75-79, and 80+ respectively. Race distribution was 81.1%, 8.3%, 7.1%, and 3.5% for Whites, Blacks, Hispanics, and Asians respectively. The mean grip strength was 71.7kg in males and 44.6kg in females, and declined as age increased (p<.0001). Blacks had the highest grip strength, followed by Whites and Hispanics, and Asians had the lowest measure (p<.0001). Although several variables were found to be correlated with grip strength univariately, after adjusting for gender, age, and race, the factors that remained significantly and independently associated with weak grip strength were lower body weight, not being in good health status, and physical limitations.
CONCLUSION: Grip strength reduced as age increased. Blacks and Whites displayed higher grip strength than Asians and Hispanics. General health status, weight status and physical functioning were independently associated with grip strength. These findings suggest that grip strength could be a useful indicator for overall health assessment in older adults.
PMID: 29150988 [PubMed - as supplied by publisher]
Psychological Aspects of Obesity in Children and Adolescents.
Indian J Pediatr. 2017 Nov 18;:
Authors: Sagar R, Gupta T
Childhood obesity is multi factorial health condition, so the simple evaluation of body fat will not be sufficed to manage the global epidemic of childhood obesity. Literature consistently provides evidence for physical health risks associated with childhood obesity; however in recent times, mental health of the obese children has also gained attention of the researchers as well as clinicians. Obese children experience number of psycho-social problems that significantly affect their quality of life and wellbeing. Co-morbid psychosocial and emotional problems of obesity generally act as causal or maintaining factors of obesity and thus significantly affect the treatment outcome. Therefore it becomes imperative for the clinicians/pediatricians to broaden their clinical assessment and include screening of important psycho-social factors within the clinical examination of childhood obesity. This article provides an evidence based comprehensive overview about the psychological factors and psychiatric factors (depression, anxiety, eating disorder, stress, body shape concerns, low self esteem) associated with childhood obesity that can further be utilized in the evaluation and management of this epidemic. The article also elaborates the role of current evidence based psychological approaches such as Cognitive Behavior Therapy (CBT) for management of obesity in children and adolescents. CBT techniques combined with lifestyle intervention and involving parents have been recommended by literature repetitively. However, there are a number of environmental, familial and personal barriers that hinder the whole process of weight loss in children. The article also discusses potential strategies to overcome those barriers.
PMID: 29150753 [PubMed - as supplied by publisher]
Novel polycondensed biopolyamide generated from biomass-derived 4-aminohydrocinnamic acid.
Appl Microbiol Biotechnol. 2017 Nov 17;:
Authors: Kawasaki Y, Aniruddha N, Minakawa H, Masuo S, Kaneko T, Takaya N
Biomass plastics are expected to contribute to the establishment of a carbon-neutral society by replacing conventional plastics derived from petroleum. The biomass-derived aromatic amine 4-aminocinnamic acid (4ACA) produced by recombinant bacteria is applied to the synthesis of high-performance biopolymers such as polyamides and polyimides. Here, we developed a microbial catalyst that hydrogenates the α,β-unsaturated carboxylic acid of 4ACA to generate 4-aminohydrocinnamic acid (4AHCA). The ability of 10 microbial genes for enoate and xenobiotic reductases expressed in Escherichia coli to convert 4ACA to 4AHCA was assessed. A strain producing 2-enoate reductase from Clostridium acetobutylicum (ca2ENR) reduced 4ACA to 4AHCA with a yield of > 95% mol mol(-1) and reaction rates of 3.4 ± 0.4 and 4.4 ± 0.6 mM h(-1) OD600(-1) at the optimum pH of 7.0 under aerobic and anaerobic conditions, respectively. This recombinant strain reduced caffeic, cinnamic, coumaric, and 4-nitrocinnamic acids to their corresponding propanoic acid derivatives. We polycondensed 4AHCA generated from biomass-derived 4ACA by dehydration under a catalyst to form high-molecular-weight poly(4AHCA) with a molecular weight of M n = 1.94 MDa. This polyamide had high thermal properties as indicated by a 10% reduction in weight at a temperature of T d10 = 394 °C and a glass transition temperature of T g = 240 °C. Poly(4AHCA) derived from biomass is stable at high temperatures and could be applicable to the production of high-performance engineering plastics.
PMID: 29150705 [PubMed - as supplied by publisher]
Immune-Enhancing Formulas for Patients With Cancer Undergoing Esophagectomy: Systematic Review Protocol.
JMIR Res Protoc. 2017 Nov 17;6(11):e214
Authors: Naranjo A, Isenring E, Teleni L
BACKGROUND: Adult patients with an esophageal cancer can potentially be compromised with postoperative leaks or fistulae if patients' nutritional status is in a vulnerable stage. Currently in Australia, there is a growing need for clinicians to know whether use of immune-enhancing formulas (IEFs) containing Arg, omega-3, and RNA are a cost-effective approach compared with isonitrogenous-isocaloric formulas to reduce postoperative infectious complications in esophagectomy patients. Since IEFs may carry higher costs, this has led to inconsistencies in practice among clinicians and hospitals.
OBJECTIVE: Our aim is to compile and present the most up-to-date nutrition evidence available regarding the provision of IEFs containing Arg, omega-3, and RNA to help clinicians develop an evidence-based nutrition care plan; identify available evidence of whether an esophagectomy patient should receive IEF; determine the cost-effectiveness and safety of such nutrition; and determine appropriate administration quantity and timing (pre-, peri-, or postesophagectomy).
METHODS: This review will include RCTs involving the use of IEFs enriched with Arg, omega-3 polyunsaturated fatty acids, and RNA in the pre-, peri-, or postoperative period (for at least 5-7 days) given orally or via enteral feeding tube, in adult cancer patients undergoing esophageal resection. Lower gastrointestinal, gastric, or head cancer surgery with parenteral nutrition or non-IEF or use of isolated immunonutrient (Arg vs omega-3 vs RNA) will be excluded. Primary outcome comprises postoperative infectious complications. Secondary outcomes (pre/postoperatively) consist of cost-effectiveness, length of stay, survival/mortality, quality of life, nutritional status, percentage of weight loss, and biochemical changes. The risk of bias will be independently assessed by the reviewers, using a domain-based evaluation tool. Blinding will be assessed for subjective and objective outcome measures. Publication bias will be visually assessed by funnel plots. A meta-analysis will be generated by the Review Manager 5.3 software and represented in forest plots.
RESULTS: The first results are expected in 2018. Outlining the protocol will ensure transparency for the completed review.
CONCLUSIONS: This protocol for a systematic review and meta-analysis will enable a comprehensive appraisal of the literature to help determine whether overall institutional savings are associated with this approach. Findings will form a knowledge base relevant to stakeholders across the health system and researchers who are involved in decision making on evidence-based nutrition care plan pathways for patients undergoing esophagectomy, as well as the use of IEF, timing, and administration quantity.
TRIAL REGISTRATION: PROSPERO Registration Number: CRD42017056908; http://www.crd.york.ac.uk/PROSPERO/ display_record.asp?
PMID: 29150418 [PubMed]
Do factors related to participation in physical activity change following restrictive bariatric surgery? A qualitative study.
Obes Res Clin Pract. 2017 Nov 14;:
Authors: Zabatiero J, Smith A, Hill K, Hamdorf JM, Taylor SF, Hagger MS, Gucciardi DF
AIMS: To explore participants' ability to participate in physical activity (PA), and barriers and facilitators to PA, at 12 months following restrictive bariatric surgery, and how these differed from participants' pre-surgery perceptions. Motivators for PA post-surgery were also explored.
METHODS: Qualitative one-on-one in-depth interviews were conducted pre- and 12 months post-surgery. Data were analysed using inductive thematic analysis.
RESULTS: Fourteen adults (12 females), with a mean (range) age of 41.4 years (25.0-56.0), body mass index (BMI) of 31.7kg/m(2) (22.3-48.2), and excess weight loss of 66% (2-127) completed both interviews. Lack of participation in PA during the first 3-6 months post-surgery was a common theme. Although participants reported increased ability to participate in PA, attributing this to a reduction in obesity-related physical barriers to PA, many participants reported that some pre-surgery obesity-related barriers to PA remained at 12 months post-surgery. For most participants, pre-surgery non-obesity related barriers to PA also remained at 12 months post-surgery. Facilitators to PA were consistent pre- and post-surgery. Weight loss and improvement in physical appearance were the most common motivators for PA post-surgery.
CONCLUSIONS: At 12 months following surgery, many participants reported residual obesity and non-obesity related barriers to PA. These barriers may explain the small, if any, pre- to post-surgery change in PA levels reported by earlier research. Facilitators to PA did not change and post-surgery motivators for PA were mostly esteem-related. These data are relevant to shape interventions aimed at optimising PA in this population.
PMID: 29150223 [PubMed - as supplied by publisher]
Esophagectomy After Weight-Reduction Surgery.
Thorac Surg Clin. 2018 Feb;28(1):53-58
Authors: Marino KA, Weksler B
Obesity is now epidemic worldwide, and an increasing number of patients have undergone a weight-loss procedure. Although obesity is a risk factor for esophageal cancer, there are few reports on esophagectomy after bariatric procedures. Careful understanding of the patient's gastroesophageal anatomy as a result of the bariatric procedure and attention to the creation of the esophageal replacement conduit are fundamental for the success of esophagectomy after bariatric surgery.
PMID: 29150037 [PubMed - in process]
Establishment of rat ankle post-traumatic osteoarthritis model induced by malleolus fracture.
BMC Musculoskelet Disord. 2017 Nov 17;18(1):464
Authors: Liang D, Sun J, Wei F, Zhang J, Li P, Xu Y, Shang X, Deng J, Zhao T, Wei L
BACKGROUND: Malleolar fracture, which is present in 37-53% of human ankle osteoarthritis (OA), is the most common type of fracture in the ankle joint. In spite of this, no rat animal model has been developed for this type of injury to date. Here, we established a rat ankle post-traumatic OA (PTOA) model induced by malleolar fracture; this model will be useful in ankle OA research.
METHODS: Two-month-old male Sprague Dawley (SD) rats were randomized into 2 groups (n = 19 per group): 1) malleolus articular fracture, dislocation, and immediate reduction on the right joints and 2) malleolus articular fracture on the right ankle. The contralateral ankle joints were used as controls. The fracture and healing processes were confirmed and monitored by radiography. Changes in inflammation were monitored in vivo by fluorescence molecular tomography (FMT). Cartilage damage and changes in expression of OA-related genes were analyzed by histology, immunohistochemistry, Real-time quantitative PCR (qPCR) and enzyme-linked immunosorbent assay (ELISA) at 8 weeks post-surgery.
RESULTS: X-rays showed that all fractures were healed at 8 weeks post-surgery. A reproducible, mild to moderate degree of OA cartilage damage with reduced aggrecan was detected by histology in all animals in both groups but there was no significant difference between the two groups. Decreased Col-II and increased Col-X and MMP-13 levels were detected by qPCR, immunohistochemistry, ELISA and FMT from both groups cartilage.
CONCLUSIONS: Malleolus articular fracture alone induces ankle OA with lesions on the central weight bearing area of the tibiotalar joint in rats. This model will provide a reproducible and useful tool for researchers to study ankle OA.
PMID: 29149841 [PubMed - in process]
Protective role of biosynthesized silver nanoparticles against early blight disease in Solanum lycopersicum.
Plant Physiol Biochem. 2017 Nov 10;121:216-225
Authors: Kumari M, Pandey S, Bhattacharya A, Mishra A, Nautiyal CS
Tomato suffers a huge loss every year because of early blight disease. This study focuses on efficient inhibition of Alternaria solani, the causative agent of early blight disease in tomato in vitro and in vivo. Foliar spray of 5 μg/mL of biosynthesized silver nanoparticles in A. solani infected plants resulted in significant increase of 32.58% in fresh weight and 23.52% in total chlorophyll content of tomato as compared to A. solani infected plants. A decrease of 48.57, 30, 39.59 and 28.57% was observed in fungal spore count, lipid peroxidation, proline content and superoxide dismutase respectively in infected tomato plants after treatment with synthesized silver nanoparticles as compared to A. solani infected plants. No significant variation in terms of soil pH, cultured population, carbon source utilization pattern and soil enzymes including dehydrogenase, urease, protenase and β-glucosidase was observed after foliar spray of nanoparticles. It was revealed that direct killing of pathogens, increased photosynthetic efficiencies, increased plant resistance and decrease in stress parameters and stress enzymes are the mechanisms employed by plants and nanoparticles simultaneously to combat the biotic stress. Biosynthesized silver nanoparticles bear the potential to revolutionize plant disease management, though the molecular aspects of increased resistance must be looked upon.
PMID: 29149700 [PubMed - as supplied by publisher]
Health effects of saturated and trans-fatty acid intake in children and adolescents: Systematic review and meta-analysis.
PLoS One. 2017;12(11):e0186672
Authors: Te Morenga L, Montez JM
BACKGROUND: Elevated cholesterol has been linked to cardiovascular disease in adults and preclinical markers of atherosclerosis in children, thus reducing saturated (SFA) and trans-fatty acids (TFA) intake from an early age may help to reduce cholesterol and the risk of cardiovascular disease later in life. The aim of this review is to examine the evidence for health effects associated with reducing SFA and TFA intake in free-living children, adolescents and young adults between 2 to 19 years of age.
DESIGN: Systematic review and meta-analysis of randomised controlled trials (RCTs) and prospective cohort studies. Study selection, assessment, validity, data extraction, and analysis were undertaken as specified by the Cochrane Collaboration and the GRADE working group. Data were pooled using inverse variance models with random effects.
DATA SOURCES: EMBASE; PubMed; Cochrane Central Register of Controlled Trials; LILACS; and WHO Clinical Trial Registry (up to July 2016).
ELIGIBILITY CRITERIA FOR SELECTING TRIALS: RCTs involving dietary interventions aiming to reduce SFA or TFA intakes and a control group, and cohort studies reporting the effects of SFA or TFA exposures, on outcomes including blood lipids; measures of growth; blood pressure; insulin resistance; and potential adverse effects. Minimum duration was 13 days for RCTs and one year for cohort studies. Trials of weight loss or confounded by additional medical or lifestyle interventions were excluded.
RESULTS: Compared with control diets, there was a highly statistically significant effect of reduced SFA intake on total cholesterol (mean difference (MD) -0.16 mmol/l, [95% confidence interval (CI): -0.25 to -0.07]), LDL cholesterol (MD -0.13 mmol/l [95% CI:-0.22 to -0.03]) and diastolic blood pressure (MD -1.45 mmol/l [95% CI:-2.34 to -0.56]). There were no significant effects on any other risk factors and no evidence of adverse effects.
CONCLUSIONS: Advice to reduce saturated fatty acids intake of children results in a significant reduction in total and LDL-cholesterol levels as well as diastolic blood pressure without evidence of adverse effects on growth and development. Dietary guidelines for children and adolescents should continue to recommend diets low in saturated fat.
PMID: 29149184 [PubMed - in process]
Adherence to Hunger Training over 6 Months and the Effect on Weight and Eating Behaviour: Secondary Analysis of a Randomised Controlled Trial.
Nutrients. 2017 Nov 17;9(11):
Authors: Jospe MR, Taylor RW, Athens J, Roy M, Brown RC
Monitoring blood glucose prior to eating can teach individuals to eat only when truly hungry, but how adherence to 'hunger training' influences weight loss and eating behaviour is uncertain. This exploratory, secondary analysis from a larger randomized controlled trial examined five indices of adherence to 'hunger training', chosen a priori, to examine which adherence measure best predicted weight loss over 6 months. We subsequently explored how the best measure of adherence influenced eating behavior in terms of intuitive and emotional eating. Retention was 72% (n = 36/50) at 6 months. Frequency of hunger training booklet entry most strongly predicted weight loss, followed by frequency of blood glucose measurements. Participants who completed at least 60 days of booklet entry (of recommended 63 days) lost 6.8 kg (95% CI: 2.6, 11.0; p < 0.001) more weight than those who completed fewer days. They also had significantly higher intuitive eating scores than those who completed 30 days or less of booklet entry; a difference (95% CI) of 0.73 (0.12, 1.35) in body-food choice congruence and 0.79 (0.06, 1.51) for eating for physical rather than emotional reasons. Adherent participants also reported significantly lower scores for emotional eating of -0.70 (-1.13, -0.27). Following hunger training and focusing on simply recording ratings of hunger on a regular basis can produce clinically significant weight loss and clinically relevant improvements in eating behaviour.
PMID: 29149038 [PubMed - in process]
Perceptions of adults with overweight/obesity and chronic musculoskeletal pain: an interpretative phenomenological analysis.
J Clin Nurs. 2017 Nov 17;:
Authors: Cooper L, Ells L, Ryan C, Martin D
AIMS: To gain insight into the lived experience of adults with overweight/obesity and chronic musculoskeletal pain (CMP). Knowledge gained will inform healthcare professionals about the complexity of the weight-pain relationship and enable more effective engagement with this population BACKGROUND: Quantitative studies show links between weight and pain. Adults with overweight/obesity are more likely to experience comorbidity however, qualitative research describing the complexities of the relationship is limited.
METHODS: A purposive sample of adults with overweight/obesity and CMP participated in face-to-face interviews. Interviews were audio-recorded, transcribed verbatim and analysed using IPA.
RESULTS: Eighteen adults (16 Female) aged 29-71, BMI ≥25-46 participated in this study. Three superordinate themes emerged: 'pain as a motivator and barrier to weight loss'; 'fear of weight causing more damage'; 'activity is positive'. Pain motivates some individuals to lose weight while simultaneously inhibiting weight-loss efforts. Participants perception that extra pressure caused by their weight further damaged joints contributed to fear and catastrophizing. Fear is often exacerbated by health care professionals' descriptions of musculoskeletal damage, or participants perception of HCPs attitude towards people with overweight/obesity. Conversely, individuals acknowledged the benefits of increased activity.
CONCLUSION: Adults with overweight/obesity and CMP in this study identified a bidirectional relationship between their weight and pain, that challenged their weight-loss efforts. Overweight/obesity contributed to fear and catastrophizing, which resulted in avoidance of exercise that would have assisted their weight loss.
RELEVANCE TO CLINICAL PRACTICE: Healthcare professionals (HCP) need to understand the complex relationship between weight and pain, and their patients understanding of that relationship. HCP should use therapeutic communication to reduce the fear of weight causing damage, and thus promote physical activities that will contribute to weight loss. It is also important to ensure that the language used with this patient group does not stigmatise individuals, or cause or exacerbate fear of normal movement. This article is protected by copyright. All rights reserved.
PMID: 29148620 [PubMed - as supplied by publisher]
Metabolic study of paeoniflorin and total paeony glucosides from Paeoniae Radix Rubra in rats by high performance liquid chromatography coupled with sequential mass spectrometry (UPLC-ESI-MS(n) ).
Biomed Chromatogr. 2017 Nov 17;:
Authors: Zhu L, Sun S, Hu Y, Liu Y
A clear understanding of the metabolism of Traditional Chinese Medicine (TCM) is extremely important in their rational clinical application and effective material foundation research. A novel and reliable strategy was performed to find more metabolites of paeoniflorin, determine the metabolites of total paeony glucosides (TPG) by means of determining those metabolites of paeoniflorin, and compare the metabolism differences between paeoniflorin and TPG by intragastric administration. This strategy was characterized as follows: firstly, the rats were divided into two groups (the paeoniflorin group and the TPG group) to find different metabolism mechanism between paeoniflorin and TPG; secondly, UPLC-FT-ICR MS and UPLC-Q-TOF MS(2) were applied to obtain accurate molecular weight and structural information respectively; thirdly, the metabolites were tentatively identified by a combination of data-processing methods including mass defect screening, characteristic neutral loss screening and product ion screening; finally, a comparative study was employed in the metabolism of paeoniflorin and TPG. Based on the strategy, eighteen metabolites of paeoniflorin (including four new compounds) and eleven metabolites of TPG (including two new compounds) were identified respectively. In all of the identified metabolites of paeoniflorin, two metabolites in rat plasma, four metabolites in rat urine and six metabolites in rat feces were found for the first time after paeoniflorin administration, respectively. The results indicated that the hydrolyzation of the ester bond and glucosidic band and the conjugation with glucuronide were the major metabolic pathways of paeoniflorin. It has been the first time to detect the metabolites of paeoniflorin and TPG in rats plasma, urine and feces after intragastric administration. The results may contribute to a better understanding of the metabolism mechanism and providing a scientific rationale for researching the material basis of paeoniflorin and TPG in vivo.
PMID: 29148594 [PubMed - as supplied by publisher]
A singular value decomposition linear programming (SVDLP) optimization technique for circular cone based robotic radiotherapy.
Phys Med Biol. 2017 Nov 17;:
Authors: Liang B, Li Y, Ran W, Guo B, Xu X, Liu B, Li J, Wu Q, Zhou F
With robot-controlled linac positioning, the robotic radiotherapy system such as CyberKnife significantly increases the freedom in radiation beam placement, but also imposes more challenges on treatment plan optimization. The resampling mechanism in vendor supplied treatment planning system (MultiPlan) could not fully explore the increased beam direction search space. Besides, a sparse treatment plan (using fewer beams) is desired to improve the treatment efficiency. This study proposes a singular value decomposition linear programming (SVDLP) optimization technique for circular collimator based robotic radiotherapy. The SVDLP approach initializes the input beams by simulating the process of covering the entire target volume with equivalent beam taper. The requirements on dosimetry distribution are modeled as hard and soft constraints, and the sparsity of treatment plan is achieved by compressive sensing. The proposed liner programming (LP) model optimizes beam weight by minimizing the deviation of soft constraints while subjecting to hard constraints, with the constraint on the <i>l</i><sup>1</sup> norm of beam weight. A singular value decomposition (SVD) based acceleration technique was developed for the LP model. Based on the degeneracy of influence matrix, the model is first compressed into lower dimension for optimization, and then back-projected to reconstruct the beam weight. After beam weight optimization, the number of beams is reduced by removing the beams with low weight, and optimizing the weight of remaining beams using the same model. This beam reduction technique is further validated by a mixed integer programming (MIP) model. The SVDLP approach was tested on a lung case. The results demonstrate that the SVD acceleration technique speeds up the optimization by a factor of 4.8. And the beam reduction achieves similar plan quality as the globally optimal plan obtained by MIP model, but is 1-2 orders of magnitude faster. Furthermore, the SVDLP approach is tested and compared with MultiPlan on three clinical cases of varying complexities. In general, the plans generated by the SVDLP achieve steeper dose gradient, better conformity and less damage to normal tissues. In conclusion, the SVDLP approach effectively improves the quality of treatment plan due to the use of complete beam search space. The challenging optimization problem with complete beam search space is effectively handled by the proposed SVD acceleration.
PMID: 29148432 [PubMed - as supplied by publisher]
Port site hernia after laparoscopic sleeve gastrectomy: a retrospective cohort study of 352 patients.
Updates Surg. 2017 Nov 16;:
Authors: Ece I, Yilmaz H, Alptekin H, Yormaz S, Colak B, Sahin M
Port site hernia (PSH) following laparoscopic procedures is a rare but serious complication. The aim of this study was to evaluate the rate of PSH after laparoscopic sleeve gastrectomy (LSG), and the efficacy of closure of the port site as a means of preventing PSH. A retrospective analysis was performed on 386 patients who underwent LSG between December 2009 and January 2015. 352 (91.2%) of the patient were followed up for at least 24 months. In the first 206 patients, the fascial layers of the trocar incisions were not closed, while in the next 146 cases, routine closure of the trocar sites was performed. The patients were reviewed in relation to demographics, comorbidities, complications, percentage of excess weight loss, and rates of PSH. The total cohort consisted of 220 female and 132 male patients with a mean age of 36.2 ± 12.3 years. Demographic data, initial BMI, and comorbidities were similar for the patients in both groups. The closure of the fascia was caused by the prolonged duration of the operation with no significant difference. The unclosed fascial defects were associated with a significantly increased incidence of PSH (1.3 vs. 3.9%, p < 0.05). All of the patients who experienced PSH had at least one comorbidity, and no complication was noted in the fascial closure cases. It was found that the rate of PSH after LSG is not as low as previously thought, and that routine closure of fascial defects at port sites may result in a decreased PSH rate.
PMID: 29147959 [PubMed - as supplied by publisher]
Efficacy and Safety of Fully Covered Self-Expanding Metal Stents for Malignant Esophageal Obstruction.
Dig Dis Sci. 2017 Nov 17;:
Authors: So H, Ahn JY, Han S, Jung K, Na HK, Lee JH, Jeong KW, Kim DH, Choi KD, Song HJ, Lee GH, Jung HY
BACKGROUND: Malignant dysphagia can result in poor nutritional status with severe weight loss. Rapid relief from dysphagia can be achieved with esophageal self-expanding metal stents (SEMSs), a minimally invasive method. In this study, we evaluated the usefulness of SEMSs for malignant dysphagia.
METHODS: Between 2012 and 2015, 119 patients with malignant dysphagia underwent esophageal SEMS insertion with endoscopic assistance. Their demographics and clinical outcomes were collected. Factors associated with stent-related complications and patient survival were evaluated. All data were retrospectively analyzed.
RESULTS: The mean age of the 119 patients was 64.9 ± 11.6 years, and 25 (21%) were female. Seventy-five patients (63.0%) had squamous carcinoma, majority of which were located in the lower thoracic esophagus (n = 42), followed by middle thoracic esophagus (n = 19) and upper esophagus (n = 10). Eighty patients (67.2%) underwent SEMS insertion at diagnosis. Technical and clinical success rates were 99.2 and 89.9%, respectively. Complications occurred in 47 patients (39.5%); the most common complication was migration (36.3%), followed by pain and obstruction. The median stent patency time was 145 days (95% confidence interval 55.19-234.81 days). Gastric cancer (odds ratio 3.51, 95% confidence interval 1.21-10.15; p = 0.021) and a 20-mm-wide stent (odds ratio 2.922, 95% confidence interval 1.237-6.904; p = 0.015) were risk factors for complications.
CONCLUSIONS: SEMSs are effective in palliation of malignant dysphagia. However, stent-related complications should be borne in mind, particularly in patients with gastric cancer with esophageal invasion and with larger width stents.
PMID: 29147877 [PubMed - as supplied by publisher]
Isolated pulmonary valve endocarditis: truth or myth?
J Community Hosp Intern Med Perspect. 2017;7(5):329-331
Authors: Seraj SM, Gill E, Sekhon S
Pulmonary valve (PV) infective endocarditis (IE) is an extremely rare disease that involves normal as well as abnormal valves. This condition mostly occurs in patients with underlying predisposing factors. It could be missed if patients do not present with typical features of right-sided endocarditis or in the absence of classic risk factors. The case presented here did not have any known risk factors for IE until surgery and presented mainly with fever, weight loss, and musculoskeletal symptoms.
PMID: 29147479 [PubMed]
The effect of educational intervention on weight loss in adolescents with overweight and obesity: Application of the theory of planned behavior.
ARYA Atheroscler. 2017 Jul;13(4):176-183
Authors: Mazloomy-Mahmoodabad SS, Navabi ZS, Ahmadi A, Askarishahi M
BACKGROUND: The increased prevalence of overweight and obesity in children and adolescents is associated with type 2 diabetes, hypertension, dyslipidemia, and cardiovascular diseases. The theory of planned behavior (TPB) efficiently explains the ability of perceived behavioral control and possibly attitude to enhance the motivations of the obese people to lose weight. Our aim was to investigate the effect of TPB-based education on weight loss in obese and overweight adolescents.
METHODS: In an interventional study, simple random sampling was used to select 86 overweight and obese adolescents aged 13-18 years in the pediatric clinic at the Isfahan Cardiovascular Research Institute. Anthropometric measures and TPB constructs were collected using a researcher-made questionnaire. The questionnaires were filled out before and six weeks after the intervention. Participants received 5 sessions of training based on the constructs of the TPB.
RESULTS: A significant increase was observed in the mean score for knowledge and TPB constructs (attitudes, subjective norms, perceived behavioral control, intention, and behavior) six weeks after the educational intervention (P < 0.001). Moreover, significant decrease in body mass index (P < 0.001), weight (P = 0.001), and waist circumference (P < 0.001) of adolescents were found after the educational intervention.
CONCLUSION: The TPB-based interventions seem to be effective in losing weight in obese and overweight adolescents. This theory serves as a helpful theoretical framework for health-related behaviors and can be an appropriate pattern to plan for educational interventions.
PMID: 29147128 [PubMed]
A Comparison of the Essential Amino Acid Content and the Retention Rate by Chicken Part according to Different Cooking Methods.
Korean J Food Sci Anim Resour. 2017;37(5):626-634
Authors: Kim H, Do HW, Chung H
This study set out to identify the changes in the nutrient contents during the chicken cooking process as basic data for the establishment of a national health nutrition policy. Samples were produced using 3 chicken parts (wing, breast, and leg) and 7 cooking methods (boiling, pancooking, pan-frying, deep-frying, steaming, roasting, and microwaving), and the essential amino acid contents, principal components, and retention rates were analyzed. Weight loss was observed in all chicken parts with all cooking methods. The protein and essential amino acid contents of the chicken samples differed significantly according to the part and the cooking method (p<0.01). The protein and essential amino acid contents (g/100 g) of raw and cooked chicken parts showed ranges of 16.81-32.36 and 0.44-2.45, respectively. The principal component analysis (PCA) clearly demonstrated that the cooking methods and chicken parts produced similar trends for the essential amino acid contents. The retention rates of the chicken parts varied with the cooking methods, yielding a minimum value of 83% for isoleucine in a roasted wing, 91% for protein in a steamed breast, and 77% for isoleucine and lysine in a roasted leg. Therefore, the protein and amino acid contents of the roasted breast were higher than those of the other cooked chicken parts.
PMID: 29147085 [PubMed]
Maraba virus-vectored cancer vaccines represent a safe and novel therapeutic option for cats.
Sci Rep. 2017 Nov 16;7(1):15738
Authors: Hummel J, Bienzle D, Morrison A, Cieplak M, Stephenson K, DeLay J, Woods JP, Lichty BD, Bridle BW
Direct killing of malignant cells combined with induction of tumour-specific immune responses makes oncolytic vaccines attractive for cancer therapy. We previously developed a heterologous cancer immunization strategy that utilized a replication-defective adenovirus-vectored primary vaccine encoding a tumour antigen followed by boosting with a replication-competent Maraba virus expressing the same antigen. To assess the safety of oncolytic Maraba virus-based booster vaccines and inform the design of clinical trials, we conducted translational studies in cats, which have immune systems that are similar to people and spontaneously develop cancers of comparable types and etiologies. A dose of Maraba virus up to 2.5 × 10(11) pfu per cat was well-tolerated, with adverse effects limited to mild, transient pyrexia, weight loss, neutropenia, lymphopenia and thrombocytopenia. Maraba viral genomes were present in some urine, stool and most plasma samples up to one week post-infection, but no infectious viruses were recovered. Post-mortem analysis showed one heart, one lung and all spleen samples contained Maraba virus genomes. No replication-competent viruses were recovered from any tissues. Post-mortem histopathological analyses revealed hyperplasia of lymphoid tissues, but no abnormal lesions were attributed to vaccination. This study demonstrated that Maraba virus-vectored cancer vaccines were well-tolerated and supports their use in treating cats.
PMID: 29146945 [PubMed - in process]
Rare cause of adrenal insufficiency.
BMJ Case Rep. 2017 Nov 16;2017:
Authors: Hii JW, Page MM, Wesseldine A
A 72-year-old man presented with weight loss, night sweats and haemoptysis and was hypotensive. CT imaging showed rapidly enlarging bilateral adrenal masses, and he was found to have primary adrenal insufficiency. An adrenal gland biopsy revealed the rare diagnosis of primary adrenal lymphoma. This unique case highlights possible rare causes of adrenal masses and adrenal insufficiency, their investigation and management principles.
PMID: 29146725 [PubMed - in process]
A randomised controlled trial of a duodenal-jejunal bypass sleeve device (EndoBarrier) compared with standard medical therapy for the management of obese subjects with type 2 diabetes mellitus.
BMJ Open. 2017 Nov 15;7(11):e018598
Authors: Glaysher MA, Mohanaruban A, Prechtl CG, Goldstone AP, Miras AD, Lord J, Chhina N, Falaschetti E, Johnson NA, Al-Najim W, Smith C, Li JV, Patel M, Ahmed AR, Moore M, Poulter N, Bloom S, Darzi A, Le Roux C, Byrne JP, Teare JP
INTRODUCTION: The prevalence of obesity and obesity-related diseases, including type 2 diabetes mellitus (T2DM), is increasing. Exclusion of the foregut, as occurs in Roux-en-Y gastric bypass, has a key role in the metabolic improvements that occur following bariatric surgery, which are independent of weight loss. Endoscopically placed duodenal-jejunal bypass sleeve devices, such as the EndoBarrier (GI Dynamics, Lexington, Massachusetts, USA), have been designed to create an impermeable barrier between chyme exiting the stomach and the mucosa of the duodenum and proximal jejunum. The non-surgical and reversible nature of these devices represents an attractive therapeutic option for patients with obesity and T2DM by potentially improving glycaemic control and reducing their weight.
METHODS AND ANALYSIS: In this multicentre, randomised, controlled, non-blinded trial, male and female patients aged 18-65 years with a body mass index 30-50 kg/m(2) and inadequately controlled T2DM on oral antihyperglycaemic medications (glycosylated haemoglobin (HbA1c) 58-97 mmol/mol) will be randomised in a 1:1 ratio to receive either the EndoBarrier device (n=80) for 12 months or conventional medical therapy, diet and exercise (n=80). The primary outcome measure will be a reduction in HbA1c by 20% at 12 months. Secondary outcome measures will include percentage weight loss, change in cardiovascular risk factors and medications, quality of life, cost, quality-adjusted life years accrued and adverse events. Three additional subgroups will investigate the mechanisms behind the effect of the EndoBarrier device, looking at changes in gut hormones, metabolites, bile acids, microbiome, food hedonics and preferences, taste, brain reward system responses to food, eating and addictive behaviours, body fat content, insulin sensitivity, and intestinal tissue gene expression.
TRIAL REGISTRATION NUMBER: ISRCTN30845205, ClinicalTrials.gov Identifier NCT02459561.
PMID: 29146657 [PubMed - in process]
Management of Adverse Events Associated with Cabozantinib Therapy in Renal Cell Carcinoma.
Oncologist. 2017 Nov 16;:
Authors: Schmidinger M, Danesi R
Cabozantinib was recently approved for the treatment of advanced renal cell carcinoma (RCC) after treatment with vascular endothelial growth factor (VEGF)-targeted therapy. Cabozantinib is a multikinase inhibitor targeting VEGF receptor (VEGFR) 2, mesenchymal-epithelial transition receptor, and "anexelekto" receptor tyrosine kinase. A 60-mg daily dose led to improved overall survival and progression-free survival (PFS) versus everolimus in advanced RCC patients as a second- or later-line treatment in the METEOR trial. Improved PFS with cabozantinib versus sunitinib has also been demonstrated in the first-line setting in CABOSUN. However, cabozantinib, like other VEGFR inhibitors, is associated with toxicity that may affect the patient's quality of life. The most frequent adverse events (AEs) are diarrhea, fatigue, hypertension, hand-foot syndrome, weight loss, nausea, and stomatitis. This article summarizes the safety profile of cabozantinib in RCC patients and offers guidance for the management of these AEs. We discuss the underlying mechanisms of these AEs and, based on our experiences with cabozantinib and other multikinase inhibitors, we present approaches to manage toxicity. Prophylactic and therapeutic solutions are available to help with the management of toxicity associated with cabozantinib, and adequate interventions can ensure optimum adherence and maximize patient outcomes.
IMPLICATIONS FOR PRACTICE: Cabozantinib leads to improved survival outcomes in renal cell carcinoma patients compared with everolimus. However, management of the adverse event profile is crucial to achieve optimum adherence and outcomes with the use of cabozantinib. This review aims to provide appropriate guidance that will minimize the impact of adverse events and help to maximize the utility of this agent in patients with advanced renal cell carcinoma.
PMID: 29146618 [PubMed - as supplied by publisher]
CART neurons in the arcuate nucleus and lateral hypothalamic area exert differential controls on energy homeostasis.
Mol Metab. 2017 Nov 08;:
Authors: Lau J, Farzi A, Qi Y, Heilbronn R, Mietzsch M, Shi YC, Herzog H
OBJECTIVE: The cocaine- and amphetamine-regulated transcript (CART) codes for a pivotal neuropeptide important in the control of appetite and energy homeostasis. However, limited understanding exists for the defined effector sites underlying CART function, as discrepant effects of central CART administration have been reported.
METHODS: By combining Cart-cre knock-in mice with a Cart adeno-associated viral vector designed using the flip-excision switch (AAV-FLEX) technology, specific reintroduction or overexpression of CART selectively in CART neurons in the arcuate nucleus (Arc) and lateral hypothalamic area (LHA), respectively, was achieved. The effects on energy homeostasis control were investigated.
RESULTS: Here we show that CART neuron-specific reintroduction of CART into the Arc and LHA leads to distinct effects on energy homeostasis control. Specifically, CART reintroduction into the Arc of otherwise CART-deficient Cart(cre/cre) mice markedly decreased fat mass and body weight, whereas CART reintroduction into the LHA caused significant fat mass gain and lean mass loss, but overall unaltered body weight. The reduced adiposity in Arc(CART);Cart(cre/cre) mice was associated with an increase in both energy expenditure and physical activity, along with significantly decreased Npy mRNA levels in the Arc but with no change in food consumption. Distinctively, the elevated fat mass in LHA(CART);Cart(cre/cre) mice was accompanied by diminished insulin responsiveness and glucose tolerance, greater spontaneous food intake, and reduced energy expenditure, which is consistent with the observed decrease of brown adipose tissue temperature. This is also in line with significantly reduced tyrosine hydroxylase (Th) and notably increased corticotropin-releasing hormone (Crh) mRNA expressions in the paraventricular nucleus (PVN).
CONCLUSIONS: Taken together, these results identify catabolic and anabolic effects of CART in the Arc and LHA, respectively, demonstrating for the first time the distinct and region-specific functions of CART in controlling feeding and energy homeostasis.
PMID: 29146410 [PubMed - as supplied by publisher]
Bariatric surgery improves lipoprotein profile in morbidly obese patients by reducing LDL cholesterol, apoB, and SAA/PON1 ratio, increasing HDL cholesterol, but has no effect on cholesterol efflux capacity.
J Clin Lipidol. 2017 Nov 08;:
Authors: Kjellmo CA, Karlsson H, Nestvold TK, Ljunggren S, Cederbrant K, Marcusson-Ståhl M, Mathisen M, Lappegård KT, Hovland A
BACKGROUND: Bariatric surgery has been shown to reduce cardiovascular events and cause-specific mortality for coronary artery disease in obese patients. Lipoprotein biomarkers relating to low-density lipoprotein (LDL), high-density lipoprotein (HDL), their subfractions, and macrophage cholesterol efflux have all been hypothesized to be of value in cardiovascular risk assessment.
OBJECTIVES: The objective of this study was to examine the effect of a lifestyle intervention followed by bariatric surgery on the lipid profile of morbidly obese patients.
METHODS: Thirty-four morbidly obese patients were evaluated before and after lifestyle changes and then 1 year after bariatric surgery. They were compared with 17 lean subjects. Several lipoprotein metrics, serum amyloid A (SAA), serum paraoxonase-1 (PON1), and macrophage cholesterol efflux capacity (CEC) were assessed.
RESULTS: Average weight loss after the lifestyle intervention was 10.5% and 1 year after bariatric surgery was 33.9%. The lifestyle intervention significantly decreased triglycerides (TGs; -28.7 mg/dL, P < .05), LDL cholesterol (LDL-C; -32.3 mg/dL, P < .0001), and apolipoprotein B (apoB; -62.9 μg/mL, P < .001). Bariatric surgery further reduced TGs (-36.7 mg/dL, P < .05), increased HDL cholesterol (+12 mg/dL, P < .0001), and reductions in LDL-C and apoB were sustained. Bariatric surgery reduced large, buoyant LDL (P < .0001), but had no effect on the small, dense LDL. The large HDL subfractions increased (P < .0001), but there was no effect on the smaller HDL subfractions. The ratio for SAA/PON1 was reduced after the lifestyle intervention (P < .01) and further reduced after bariatric surgery (P < .0001). Neither the lifestyle intervention nor bariatric surgery had any effect on CEC.
CONCLUSIONS: Lifestyle intervention followed by bariatric surgery in 34 morbidly obese patients showed favorable effects on TGs, LDL-C, and apoB. HDL cholesterol and apoA1 was increased, apoB/apoA1 ratio as well as SAA/PON1 ratio reduced, but bariatric surgery did not influence CEC.
PMID: 29146227 [PubMed - as supplied by publisher]
Early erythropoiesis-stimulating agents in preterm or low birth weight infants.
Cochrane Database Syst Rev. 2017 Nov 16;11:CD004863
Authors: Ohlsson A, Aher SM
BACKGROUND: Preterm infants have low plasma levels of erythropoietin (EPO), providing a rationale for the use of erythropoiesis-stimulating agents (ESAs) to prevent or treat anaemia and to provide neuro protection and protection against necrotising enterocolitis (NEC). Darbepoetin (Darbe) and EPO are currently available ESAs.
OBJECTIVES: To assess the effectiveness and safety of ESAs (erythropoietin (EPO) and/or Darbe) initiated early (before eight days after birth) compared with placebo or no intervention in reducing red blood cell (RBC) transfusions, adverse neurological outcomes, and feeding intolerance including necrotising enterocolitis (NEC) in preterm and/or low birth weight infants. Primary objective for studies that primarily investigate the effectiveness and safety of ESAs administered early in reducing red blood cell transfusions:To assess the effectiveness and safety of ESAs initiated early in reducing red blood cell transfusions in preterm infants. Secondary objectives:Review authors performed subgroup analyses of low (≤ 500 IU/kg/week) and high (> 500 IU/kg/week) doses of EPO and the amount of iron supplementation provided: none, low (≤ 5 mg/kg/d), and high (> 5 mg/kg/d). Primary objective for studies that primarily investigate the neuro protective effectiveness of ESAs:To assess the effectiveness and safety of ESAs initiated early in reducing adverse neurological outcomes in preterm infants. Primary objective for studies that primarily investigate the effectiveness of EPO or Darbe administered early in reducing feeding intolerance:To assess the effectiveness and safety of ESAs administered early in reducing feeding intolerance (and NEC) in preterm infants. Other secondary objectives:To compare the effectiveness of ESAs in reducing the incidence of adverse events and improving long-term neurodevelopmental outcomes.
SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 2), MEDLINE via PubMed (1966 to 10 March 2017), Embase (1980 to 10 March 2017), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to 10 March 2017). We searched clinical trials databases, conference proceedings, and reference lists of retrieved articles for randomised and quasi-randomised controlled trials.
SELECTION CRITERIA: Randomised and quasi-randomised controlled trials of early initiation of EAS treatment versus placebo or no intervention in preterm or low birth weight infants.
DATA COLLECTION AND ANALYSIS: We used the methods described in the Cochrane Handbook for Systematic Reviews of Interventions and the GRADE approach to assess the quality of evidence.
MAIN RESULTS: This updated review includes 34 studies enrolling 3643 infants. All analyses compared ESAs versus a control consisting of placebo or no treatment.Early ESAs reduced the risk of 'use of one or more [red blood cell] RBC transfusions' (typical risk ratio (RR) 0.79, 95% confidence interval (CI) 0.74 to 0.85; typical risk difference (RD) -0.14, 95% CI -0.18 to -0.10; I(2) = 69% for RR and 62% for RD (moderate heterogeneity); number needed to treat for an additional beneficial outcome (NNTB) 7, 95% CI 6 to 10; 19 studies, 1750 infants). The quality of the evidence was low.Necrotising enterocolitis was significantly reduced in the ESA group compared with the placebo group (typical RR 0.69, 95% CI 0.52 to 0.91; typical RD -0.03, 95% CI -0.05 to -0.01; I(2) = 0% for RR and 22% for RD (low heterogeneity); NNTB 33, 95% CI 20 to 100; 15 studies, 2639 infants). The quality of the evidence was moderate.Data show a reduction in 'Any neurodevelopmental impairment at 18 to 22 months' corrected age in the ESA group (typical RR 0.62, 95% CI 0.48 to 0.80; typical RD -0.08, 95% CI -0.12 to -0.04; NNTB 13, 95% CI 8 to 25. I(2) = 76% for RR (high heterogeneity) and 66% for RD (moderate); 4 studies, 1130 infants). The quality of the evidence was low.Results reveal increased scores on the Bayley-II Mental Development Index (MDI) at 18 to 24 months in the ESA group (weighted mean difference (WMD) 8.22, 95% CI 6.52 to 9.92; I(2) = 97% (high heterogeneity); 3 studies, 981 children). The quality of the evidence was low.The total volume of RBCs transfused per infant was reduced by 7 mL/kg. The number of RBC transfusions per infant was minimally reduced, but the number of donors to whom infants who were transfused were exposed was not significantly reduced. Data show no significant difference in risk of stage ≥ 3 retinopathy of prematurity (ROP) with early EPO (typical RR 1.24, 95% CI 0.81 to 1.90; typical RD 0.01, 95% CI -0.02 to 0.04; I(2) = 0% (no heterogeneity) for RR; I(2) = 34% (low heterogeneity) for RD; 8 studies, 1283 infants). Mortality was not affected, but results show significant reductions in the incidence of intraventricular haemorrhage (IVH) and periventricular leukomalacia (PVL).
AUTHORS' CONCLUSIONS: Early administration of ESAs reduces the use of red blood cell (RBC) transfusions, the volume of RBCs transfused, and donor exposure after study entry. Small reductions are likely to be of limited clinical importance. Donor exposure probably is not avoided, given that all but one study included infants who had received RBC transfusions before trial entry. This update found no significant difference in the rate of ROP (stage ≥ 3) for studies that initiated EPO treatment at less than eight days of age, which has been a topic of concern in earlier versions of this review. Early EPO treatment significantly decreased rates of IVH, PVL, and NEC. Neurodevelopmental outcomes at 18 to 22 months and later varied in published studies. Ongoing research should evaluate current clinical practices that will limit donor exposure. Promising but conflicting results related to the neuro protective effect of early EPO require further study. Very different results from the two largest published trials and high heterogeneity in the analyses indicate that we should wait for the results of two ongoing large trials before drawing firm conclusions. Administration of EPO is not currently recommended because limited benefits have been identified to date. Use of darepoetin requires further study.
PMID: 29145693 [PubMed - as supplied by publisher]
Root respiratory burst oxidase homologue-dependent H2O2 production confers salt tolerance on a grafted cucumber by controlling Na+ exclusion and stomatal closure.
J Exp Bot. 2017 Nov 14;:
Authors: Niu M, Huang Y, Sun S, Sun J, Cao H, Shabala S, Bie Z
Plant salt tolerance can be improved by grafting onto salt-tolerant rootstocks. However, the underlying signaling mechanisms behind this phenomenon remain largely unknown. To address this issue, we used a range of physiological and molecular techniques to study responses of self-grafted and pumpkin-grafted cucumber plants exposed to 75 mM NaCl stress. Pumpkin grafting significantly increased the salt tolerance of cucumber plants, as revealed by higher plant dry weight, chlorophyll content and photochemical efficiency (Fv/Fm), and lower leaf Na+ content. Salinity stress resulted in a sharp increase in H2O2 production, reaching a peak 3 h after salt treatment in the pumpkin-grafted cucumber. This enhancement was accompanied by elevated relative expression of respiratory burst oxidase homologue (RBOH) genes RbohD and RbohF and a higher NADPH oxidase activity. However, this increase was much delayed in the self-grafted plants, and the difference between the two grafting combinations disappeared after 24 h. The decreased leaf Na+ content of pumpkin-grafted plants was achieved by higher Na+ exclusion in roots, which was driven by the Na+/H+ antiporter energized by the plasma membrane H+-ATPase, as evidenced by the higher plasma membrane H+-ATPase activity and higher transcript levels for PMA and SOS1. In addition, early stomatal closure was also observed in the pumpkin-grafted cucumber plants, reducing water loss and maintaining the plant's hydration status. When pumpkin-grafted plants were pretreated with an NADPH oxidase inhibitor, diphenylene iodonium (DPI), the H2O2 level decreased significantly, to the level found in self-grafted plants, resulting in the loss of the salt tolerance. Inhibition of the NADPH oxidase-mediated H2O2 signaling in the root also abolished a rapid stomatal closure in the pumpkin-grafted plants. We concluded that the pumpkin-grafted cucumber plants increase their salt tolerance via a mechanism involving the root-sourced respiratory burst oxidase homologue-dependent H2O2 production, which enhances Na+ exclusion from the root and promotes an early stomatal closure.
PMID: 29145593 [PubMed - as supplied by publisher]
Lifestyle intervention program in deprived obese adult patients and their non-deprived counterparts.
PLoS One. 2017;12(11):e0188297
Authors: Loddo C, Pupier E, Amour R, Monsaingeon-Henry M, Mohammedi K, Gatta-Cherifi B
INTRODUCTION: Although it is known that the prevalence of obesity is high in deprived patients, the link between deprivation and obesity, and the impact of deprivation on compliance and efficacy of a lifestyle intervention program are not known.
MATERIALS AND METHODS: Deprivation was assessed in 40 patients (23 Females, mean±SD age: 49±17 years) from the diabetology department and 140 patients (101 Females, age: 50±15 years) from the nutrition department of Bordeaux University hospital. Eighty-seven patients suffering from obesity were evaluated before and after a tailored, multidisciplinary lifestyle intervention. Deprivation was assessed using EPICES scores. Deprivation was defined with an EPICES score > 30.
RESULTS: Deprived patients suffering from obesity had significantly higher current (43.8 ±8.4 versus 40.9 ± 5.5 kg/m2, p = 0,02) and maximal BMI (46.1± 8.6 versus 42.3± 5.2 kg/m2, p = 0.002) compared to non-deprived obese. Percentage of body weight loss was not different according to deprivation (4.74 ± 0.75 versus 4.65 ± 1.04%, p = 0.9). EPICES scores were not different according to adherence to lifestyle intervention program (20.5 ± 8.5 versus 29.9 ± 3.9 versus 29.0 ±2.5, no follow up versus partial follow up versus total follow up, p = 0,58).
CONCLUSION: Deprived patients suffering from obesity have a more serious disease than non-deprived patients. However, neither compliance to the lifestyle intervention program nor body weight loss differed between deprived patients with obesity and non-deprived ones. Deprivation should not be a limitation when enrolling patients with obesity in lifestyle intervention programs.
PMID: 29145484 [PubMed - in process]
Morphological and molecular characterization of Brazilian populations of Diatraea saccharalis (Fabricius, 1794) (Lepidoptera: Crambidae) and the evolutionary relationship among species of Diatraea Guilding.
PLoS One. 2017;12(11):e0186266
Authors: Francischini FJB, de Campos JB, Alves-Pereira A, Gomes Viana JP, Grinter CC, Clough SJ, Zucchi MI
The sugarcane borer or corn stalk borer, Diatraea Guilding is polyphagous insect pest of many important crops such as corn, sorghum and sugarcane. Losses arising from the attack of Diatraea species have been a serious problem, which may cause loss in sugarcane production around 0.25% in sugar, 0.20% in alcohol and 0.77% of body weight for every 1% infestation and up to 21% in corn production fields. In Brazil, the most commonly reported species are Diatraea saccharalis (Fabricius, 1794) and Diatraea impersonatella (Walker, 1863) (= D. flavipennella). However, multiple other species of Diatraea have been identified in Brazil according to the literature. Currently, little information exists on the presence of the other species causing injury to sugarcane and corn. The objectives of this study were to improve the accuracy of species assignment, evaluate the population genetic structure, and address many of the outstanding questions of systematics and evolution of Brazilian populations of D. saccharalis. To address these main questions, classical taxonomic methods were used, focused on morphological characterization of the reproductive organs, especially the male genitalia. In addition, genetic studies were performed using simple sequence repeats (SSR) and a fragment of cytochrome C oxidase subunit I (COI) gene. The data and findings from this research will contribute to the understanding of evolutionary aspects of insect pests in order to develop more effective and sustainable population management practices.
PMID: 29145390 [PubMed - in process]
Effectiveness of bariatric surgical procedures: A systematic review and network meta-analysis of randomized controlled trials.
Medicine (Baltimore). 2017 Nov;96(46):e8632
Authors: Kang JH, Le QA
BACKGROUND: Bariatric surgery has proved to be an effective strategy in treating obesity. However, randomized controlled trials (RCTs) of 3 most common bariatric surgery procedures, Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and laparoscopic adjustable gastric band (LAGB), reported inconsistent results. We performed a systematic review and network meta-analysis to synthesize evidence of effectiveness of the 3 common bariatric procedures from relevant RCTs.
METHODS: The present study was a systematic review and network meta-analysis of RCTs. All RCTs must meet the following criteria to be included in the analysis: patients with body mass index (BMI) ≥30 kg/m, reported at least 1 outcome of interest, compared at least 2 of the 3 bariatric procedures, and had follow-ups of at least 1 year. Primary outcome was weight loss, expressed as differences in mean BMI reduction and percentage excess weight loss (%EWL) following 1 year after the surgery. Network meta-analysis was based on Bayesian framework with Markov Chain Monte Carlo simulation approach.
RESULTS: Eleven RCTs that met the criteria were included in the review. Of 9 trials (n = 765), the differences in mean BMI reduction were -0.76 (95% CI: -3.1 to 1.6) for RYGB versus SG, -5.8 (95% CI: -9.2 to -2.4) for RYGB versus LAGB, and -5.0 (95% CI: -9.0 to -1.0) for SG versus LAGB. Eight RCTs (n = 656) reported percentage excess weight-loss (%EWL), the mean differences between RYGB and SG, RYGB and LAGB, and SG and LAGB were 3.8% (95% CI: -8.5% to 13.8%), -22.2% (95% CI: -34.7% to -6.5%), and -26.0% (95% CI: -40.6% to -6.4%), respectively. The meta-analysis indicated low heterogeneity between studies, and the node splitting analysis showed that the studies were consistent between direct and indirect comparisons (P > .05).
CONCLUSION: The RYGB and SG yielded similar in weight-loss effect and both were superior to LAGB. Other factors such as complications and patient preference should be considered during surgical consultations.
PMID: 29145284 [PubMed - in process]
Comparison of Efficacy and Safety of Liraglutide 3.0 mg in Individuals with BMI above and below 35 kg/m²: A Post-hoc Analysis.
Obes Facts. 2017 Nov 17;10(6):531-544
Authors: le Roux C, Aroda V, Hemmingsson J, Cancino AP, Christensen R, Pi-Sunyer X
OBJECTIVE: To investigate whether the efficacy and safety of liraglutide 3.0 mg differed between two subgroups, BMI 27 to <35 and BMI ≥ 35 kg/m², in individuals without and with type 2 diabetes (T2D).
METHODS: A post-hoc analysis of two 56-week, randomized, double-blind, placebo-controlled trials (SCALE Obesity and Prediabetes; SCALE Diabetes). Subgroup differences in treatment effects of liraglutide 3.0 mg were evaluated by testing the interaction between treatment group and baseline BMI subgroup.
RESULTS: Significantly greater weight loss (0-56 weeks) was observed with liraglutide 3.0 mg versus placebo in all patient groups while on treatment. There was no evidence that the weight-lowering effect of liraglutide 3.0 mg differed between BMI subgroups (interaction p > 0.05). Similarly, for most secondary endpoints significantly greater improvements were observed with liraglutide 3.0 mg versus placebo, with no indication treatment effects differing between subgroups. The safety profile of liraglutide 3.0 mg was broadly similar across BMI subgroups.
CONCLUSION: This post-hoc analysis did not indicate any differences in the treatment effects, or safety profile, of liraglutide 3.0 mg for individuals with BMI 27 to <35 or ≥35 kg/m². Liraglutide 3.0 mg can therefore be considered for individuals with a BMI of ≥35 as well as for those with a BMI of 27 to <35 kg/m².
PMID: 29145215 [PubMed - as supplied by publisher]
Evaluation of anti-urolithiatic and diuretic activities of watermelon (Citrullus lanatus) using in vivo and in vitro experiments.
Biomed Pharmacother. 2017 Nov 11;97:1212-1221
Authors: Siddiqui WA, Shahzad M, Shabbir A, Ahmad A
Traditionally, Citrullus lanatus is known to have protective properties in kidney diseases and for having the ability to clear urine. Current study aims to validate the traditional uses of C. lanatus by evaluation of anti-urolithiatic and diuretic activities using in vivo and in vitro experiments. Male Wistar rats were used for in vivo anti-urolithiatic and diuretic activities. Supersaturated solution of calcium and oxalate was used for in vitro crystallization study. Hematoxylin & eosin staining was used for histopathological evaluation of kidney. In the in vivo rat model of urolithiasis, the pulp extract reduced calcium oxalate (CaOX) crystal count in both kidney and urine. The pulp extract also increased the urinary pH and output, and prevented the weight loss. Serum analysis showed elevation in creatinine clearance and reduction in urea and creatinine levels. Urinary analysis demonstrated that pulp extract restored altered phosphate, calcium, oxalate, and citrate levels. In the in vivo rat model of diuresis; the pulp extract produced diuresis, reduced serum chloride levels, and elevated urinary sodium and chloride levels. In the in vitro crystallization experiment, pulp extract inhibited the aggregation phase. Seed extract failed to show any convincing results. GC-MS analysis revealed the presence of steroids and alkanes as the major constituents of pulp extract, which might be responsible for anti-urolithiatic activity; however, further studies are required for isolation and identification of active constituents. Current study validated the traditional uses of watermelon and demonstrated that pulp extract possessed significant anti-urolithiatic and diuretic activities.
PMID: 29145146 [PubMed - as supplied by publisher]
The use of hardened bone cement as an impaction grafting extender for revision hip arthroplasty.
J Mech Behav Biomed Mater. 2017 Nov 13;78:82-90
Authors: Ruddy M, FitzPatrick DP, Stanton KT
Impaction bone grafting is a method of restoring bone stock to patients who have suffered significant bone loss due to revision total hip surgery. The procedure requires morsellised cancellous bone (MCB) to be impacted into the site of bone loss in order to stabilise the prosthesis with the aim of long term resorption and reintegration of the impacted bone graft. Due to financial cost and the potential to transmit disease, the use of supplementary material, known as an extender, is frequently used to increase the graft material volume. This study investigates the use of hardened Hydroset (Stryker Corp, MA, USA), an injectable bone cement (IBC), as an extender material and compares the performance of the IBC in different weight percent inclusions to a commercially available bone graft extender (GCP, BoneSave, Stryker Corp, MA, USA). The surgical impaction procedure was standardised and samples were evaluated in terms of graft stiffness and height. It was observed that 30wt% IBC extended samples had significantly improved graft stiffness (p = 0.02) and no significant different in height (p = 0.067) over a 100% MCB control sample. Cyclic loading, representative of gait, found that the IBC subsided similarly to the commercial bone substitute in wt% above 10%. Shear testing of the impacted grafts showed no significant differences between GCP and IBC with impaction forces determining the shear parameters of impacted grafts. The effects of the impaction and cyclical loading procedures on extender particle sizes was assessed via particle size analysis. It was found that the IBC extended samples demonstrated reduced friability, evident in the better retention of particle size as a result of both impaction and gait representative loading compared to that of the GCP samples. This indicates a potential reduction in issues arising from small particle migration to joint surfaces. Scanning electron microscopy of the MCB particles with both GCP and IBC as extenders showed retention of the porous trabecular structure post-testing which is essential for revascularisation and bone growth into the graft.
PMID: 29145010 [PubMed - as supplied by publisher]
Evaluate the effects of antiepileptic drugs on reproductive endocrine system in newly diagnosed female epileptic patients receiving either Valproate or Lamotrigine monotherapy: A prospective study.
Epilepsy Res. 2017 Oct 28;139:20-27
Authors: Sidhu HS, Srinivasa R, Sadhotra A
OBJECTIVE: To investigate the development of reproductive endocrine changes in Indian women with epilepsy initiating on either Valproate (VPA) or Lamotrigine (LTG) monotherapy.
METHODS: Reproductive hormonal profiles, hirsutism, ovarian morphology by ultrasonography and menstrual cycle data in newly diagnosed women with epilepsy taking VPA (n=34) or LTG (n=32) monotherapy were compared. None of the women were receiving hormonal contraception. Patients gave details of seizure type and frequency, medical and drug history. Body weight and fasting insulin, glucose, testosterone, dihyroepiandrosterone sulfate (DHEAS), androstenedione, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), follicle-stimulating hormone (FSH) were measured. Body mass index, free androgen index and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. Longitudinal evaluations were done at 6th month and at 12th month. After 12th month some VPA-treated women were replaced with LTG and further followed-up twice in next six months.
RESULTS: The mean testosterone level was significant increased in VPA-treated women at 6th month (p=0.03), then at 12th month (p=0.01). More women in the valproate group than the lamotrigine group developed hirsutism (p=0.06), menstrual disturbances (p=0.02) and PCOS (p=0.001). Before valproate therapy, 32% of the patients were obese, this percentage rose to 47% after treatment (p=0.03). A significant positive correlation was existed between obesity (BMI >25) and the development of menstrual disturbances (p=0.006), serum testosterone levels (p=0.02) and PCOS (p=0.03). Insulin resistance (HOMA-IR >2.5) was significant correlated with menstrual disturbances (p=0.03) and serum testosterone levels (p=0.02). Substitution of VPA with LTG results in significant reduction in mean testosterone levels (p=0.005) and means body weight at 6th month (p=0.01).
CONCLUSION: Long-term valproate therapy in Indian women with epilepsy was associated with development of menstrual disturbances, alterations in reproductive hormonal function and increased the risk to developed PCOS.
PMID: 29144993 [PubMed - as supplied by publisher]
INCREASED BONE TURNOVER IN TYPE 2 DIABETES PATIENTS RANDOMIZED TO BARIATRIC SURGERY VS. MEDICAL THERAPY AT 5 YEARS.
Endocr Pract. 2017 Nov 16;:
Authors: Crawford MR, Pham N, Khan L, Bena JF, Schauer PR, Kashyap SR
OBJECTIVE: The aim of our study was to determine the 5 year outcomes of bariatric surgery vs. intensive medical therapy on bone turnover in patients with type 2 diabetes (T2DM) from the STAMPEDE trial.
METHODS: This is an ancillary investigation of a 5 year randomized control trial at a single tertiary care center involving 95 patients aged 48.5 ± 8 years with obesity (BMI: 36.5±3.6 kg/m(2)) and uncontrolled T2DM (HbA1C: 9.3 ±1.6%). Patients were randomized to intensive medical therapy (IMT; N=25), Roux-en-Y gastric bypass (RYGB; N=37), or sleeve gastrectomy (SG; N=33) for diabetes treatment. Bone formation marker osteocalcin (OC), bone resorption marker serum C-telopeptide of type 1 collagen (CTX), and intact parathyroid hormone (PTH) were assessed at baseline and 5 years post-intervention. Analysis with key clinical parameters and outcomes (i.e. age, menopausal status, gender, weight loss) was performed.
RESULTS: Percent change in CTX at 5 years increased in both surgical groups, by 137 ±108% in RYGB (p<0.001), 61.1±90% in SG (p<0.001) compared to 29.8±93% in IMT (p=0.12). OC also increased from baseline in the surgical cohorts, by 138±19% in RYGB (p<0.001) and 71±69% in SG (p<0.001), compared to 43.8 ±121.1% in IMT (p=0.83). Increases in both CTX and OC correlated linearly with increases in PTH levels in RYGB patients (p<0.001). Increase in CTX correlated with decreased BMI in SG patients (p=0.039).
CONCLUSIONS: In patients with T2DM, bone turnover remains chronically elevated at 5 years following RYGB, and to a lesser extent in SG patients.
ABBREVIATIONS: BTM = bone turnover marker; BMI = body mass index; T2DM = type 2 diabetes.
PMID: 29144812 [PubMed - as supplied by publisher]
The role of glucagon in weight loss-mediated metabolic improvement: a systematic review and meta-analysis.
Obes Rev. 2017 Nov 16;:
Authors: Silvestre MP, Goode JP, Vlaskovsky P, McMahon C, Tay A, Poppitt SD
Aims This meta-analysis aimed to investigate the role of glucagon suppression in regulating glucose homeostasis following diet or bariatric surgery. Methods A comprehensive search of intervention and observational studies was conducted in Medline, Scopus, Web of Science, PubMed and Embase. Random effects model meta-analysis was performed. Primary outcomes were (i) body weight change, (ii) fasting glucagon, (iii) fasting glucose and (iv) fasting insulin concentrations. Results Twenty articles reporting data from 29 interventions were eligible for analysis. Bariatric surgery caused greater weight loss than diet (bariatric -29.7 kg [CI:-36.8, -22.6]; diet -5.8 kg [CI: -8.4, -3.3]; P < 0.00001), an effect that remained significant after adjusting for study duration (P < 0.05). Mean fasting glucagon decreased in parallel with weight loss (-11.8 ng/L [CI: -15.9, -7.8]; P < 0.00001) with no difference between bariatric and diet intervention. Both fasting glucose, and insulin decreased following weight loss (both P < 0.00001; glucose -1.7 mmol/L [CI: -2.0, -1.3]; insulin -50.6 pmol/L [CI: -66.5, -34.7] with greater decrease in fasting insulin between bariatric versus diet (P = 0.01). Conclusions Synergistic suppression of fasting glucagon and insulin resistance may act together to restore normoglycaemia following weight loss. Whether suppression of plasma glucagon may contribute to increased hunger after weight loss and gradual weight regain is not yet known.
PMID: 29144030 [PubMed - as supplied by publisher]
Sclerosing mesenteritis diagnosed with computed tomography and ultrasound-guided needle biopsy: the utility of the coaxial technique.
Clin J Gastroenterol. 2017 Nov 16;:
Authors: Ueno M, Nishimura N, Shimodate Y, Doi A, Mouri H, Matsueda K, Yamamoto H, Mizuno M
Here we report a case of sclerosing mesenteritis that we diagnosed with needle biopsy under the guidance of computed tomography (CT) and ultrasound (US) observation. An 82-year-old woman presented with appetite loss, weight loss and epigastric pain. CT of the abdomen and pelvis revealed increased density of the mesentery adjacent to the small bowel and enlarged lymph nodes. Sclerosing mesenteritis was suspected, but malignancies, such as lymphoma, were also considered. We performed CT and US-guided needle biopsy with the coaxial technique. An introducer needle was inserted, its correct location was documented with CT, and multiple specimens were taken with a finer needle passed through the introducer without incident. Adequate specimens were obtained, and the histological diagnosis of sclerosing mesenteritis was made. We treated the patient with corticosteroids and her symptoms and the radiographic findings improved. The coaxial technique was a useful and minimally invasive tool for making the diagnosis of sclerosing mesenteritis.
PMID: 29143914 [PubMed - as supplied by publisher]
Use of Novel High-Protein Functional Food Products as Part of a Calorie-Restricted Diet to Reduce Insulin Resistance and Increase Lean Body Mass in Adults: A Randomized Controlled Trial.
Nutrients. 2017 Oct 28;9(11):
Authors: Johnston CS, Sears B, Perry M, Knurick JR
Significant reductions in insulin resistance (IR) can be achieved by either calorie restriction or by the increase of lean mass. However, calorie restriction usually results in significant loss of lean mass. A 6-week randomized controlled feeding trial was conducted to determine if a calorie-restricted, high-protein diet (~125 g protein/day consumed evenly throughout the day) using novel functional foods would be more successful for reducing IR in comparison to a conventional diet (~80 g protein/day) with a similar level of calorie restriction. Healthy adults (age 20-75 years; body mass index, 20-42 kg/m²) with raised triglyceride/high-density lipoprotein ratios were randomly assigned to the control group (CON: test foods prepared using gluten-free commercial pasta and cereal) or to the high-protein group (HPR: test foods prepared using novel high-protein pasta and cereal both rich in wheat gluten). Mean weight loss did not differ between groups (-2.7 ± 2.6 and -3.2 ± 3.0 kg for CON (n = 11) and HPR (n = 10) respectively, p = 0.801); however, the 6-week change in fat-free mass (FFM) differed significantly between groups (-0.5 ± 1.5 and +1.5 ± 3.8 kg for CON and HPR respectively, p = 0.008). IR improved in HPR vs. CON participants (homeostasis model assessment-estimated insulin resistance [HOMAIR] change: -1.7 ± 1.4 and -0.7 ± 0.7 respectively; p = 0.020). The change in HOMA-IR was related to the change in FFM among participants (r = -0.511, p = 0.021). Thus, a high-protein diet using novel functional foods combined with modest calorie restriction was 140% more effective for reducing HOMA-IR in healthy adults compared to a lower protein, standard diet with an equal level of calorie restriction.
PMID: 29143803 [PubMed - in process]
Polyphosphates as Inhibitors for Poly(vinyl Chloride) Photodegradation.
Molecules. 2017 Oct 28;22(11):
Authors: Ahmed DS, El-Hiti GA, Yousif E, Hameed AS
Three polyphosphates were used as inhibitors for poly(vinyl chloride) (PVC) photodegradation. The polyphosphates were added to PVC at a concentration of 0.5% by weight. The PVC films (40 µm thickness) were irradiated at room temperature with ultraviolet (UV) light for up to 300 h. The changes in PVC films after irradiation were monitored by Fourier transform infrared spectroscopy, weight loss, viscosity-average molecular weight determination, and atomic force microscopy. These changes were very noticeable in the blank PVC films compared to the ones obtained when additives were used. The polyphosphates can inhibit the PVC photodegradation through direct absorption of UV light, interactions with PVC chains, and acting as radical scavengers.
PMID: 29143792 [PubMed - in process]
Metformin Potentiates the Benefits of Dietary Restraint: A Metabolomic Study.
Int J Mol Sci. 2017 Oct 28;18(11):
Authors: Riera-Borrull M, García-Heredia A, Fernández-Arroyo S, Hernández-Aguilera A, Cabré N, Cuyàs E, Luciano-Mateo F, Camps J, Menendez JA, Joven J
Prevention of the metabolic consequences of a chronic energy-dense/high-fat diet (HFD) represents a public health priority. Metformin is a strong candidate to be incorporated in alternative therapeutic approaches. We used a targeted metabolomic approach to assess changes related to the multi-faceted metabolic disturbances provoked by HFD. We evaluated the protective effects of metformin and explored how pro-inflammatory and metabolic changes respond when mice rendered obese, glucose-intolerant and hyperlipidemic were switched to diet reversal with or without metformin. Mice treated with metformin and diet-reversal showed a dramatically improved protection against HFD-induced hepatic steatosis, a beneficial effect that was accompanied by a lowering of liver-infiltrating pro-inflammatory macrophages and lower release of pro-inflammatory cytokines. Metformin combined with diet reversal promoted effective weight loss along with better glucose control, lowered levels of circulating cholesterol and triglycerides, and reduced adipose tissue content. Our findings underscored the ability of metformin to target the contribution of branched chain amino acids to adipose tissue metabolism while suppressing mitochondrial-dependent biosynthesis in hepatic tissue. The relationship between adipose tissue and liver might provide clinical potential for combining metformin and dietary modifications to protect against the metabolic damage occurring upon excessive dietary fat intake.
PMID: 29143783 [PubMed - in process]
Effect of heartworm disease and heartworm-associated respiratory disease (HARD) on the right ventricle of cats.
Parasit Vectors. 2017 Nov 09;10(Suppl 2):492
Authors: Winter RL, Ray Dillon A, Cattley RC, Blagburn BL, Michael Tillson D, Johnson CM, Brawner WR, Welles EG, Barney S
BACKGROUND: Dirofilaria immitis infection occurs in dogs and cats, both of which species are clinically affected by mature adult infections. Cats are uniquely affected by immature-adult infections with an inflammatory pulmonary disease called Heartworm-Associated Respiratory Disease (HARD). D. immitis infection causes pulmonary parenchymal and vascular pathology in the dog and cat. Dogs develop pulmonary hypertension and cor pulmonale, whereas the development of pulmonary hypertension is rare in the cat. D. immitis infection in the dog causes alteration of the right ventricular (RV) extracellular matrix, including a decrease in myocardial collagen. In this study, the RV myocardial changes of cats infected with adult and immature-adult D. immitis were assessed.
METHODS: The cardiopulmonary systems of six groups of SPF cats (n = 9-10 per group) were examined 8 or 18 months after infection with L3 D. immitis. Two groups were untreated and allowed to develop adult HW; two groups were treated with ivermectin starting 3 months post infection, thus allowing HARD but no mature adult heartworms; and two groups were treated with selamectin beginning 1 month post infection, preventing development of L5 or adult heartworms. A group of specific pathogen free (SPF) normal cats was utilized as a negative control (n = 12). Lung pathologic lesions were objectively assessed, and both RV and left ventricular (LV) weights were obtained to calculate an RV/LV ratio. Intramural RV myocardial collagen content was quantitatively assessed.
RESULTS: RV/LV weight ratios were not different between groups. Negative control cats had significantly greater RV collagen content than all other affected groups (P = 0.032). Analysis of the RV/LV ratios and collagen content revealed no significant relationship (r = 0.03, P = 0.723, respectively). Collagen content had a modest, but significant, negative correlation, however, with both pulmonary vascular pathology (r = -0.25, P = 0.032) as well as the total pulmonary parenchymal and vascular pathology (r = -0.26, P = 0.025).
CONCLUSIONS: Cats infected with mature and immature D. immitis did not develop RV hypertrophy but did demonstrate loss of RV myocardial collagen content. The collagen loss was present at 8 and 18 months after infection in all infected cats. This loss of RV myocardial collagen was correlated with the severity of pulmonary parenchymal and vascular pathology.
PMID: 29143659 [PubMed - in process]
Multiscale characterisation of cortical bone composition, microstructure, and nanomechanical properties in experimentally-induced osteoporosis.
J Biomed Mater Res A. 2017 Nov 16;:
Authors: Shah FA, Stoica A, Cardemil C, Palmquist A
Cortical bone plays a vital role in determining overall bone strength. We investigate the structural, compositional, and nanomechanical properties of cortical bone following ovariectomy (OVX) of 12 week old Sprague Dawley rats, since this animal model is frequently employed to evaluate the performance of implantable biomaterials in compromised bone healing conditions. Morphological parameters and material properties of bone in the geometrical centre of the femoral cortex were investigated four and eight weeks post-OVX and in unoperated controls (Ctrl), using X-ray micro-computed tomography, backscattered electron scanning electron microscopy, Raman spectroscopy, and nanoindentation. The OVX animals showed increase in body weight, diminished bone mineral density, increased intracortical porosity, but increased bone mass through periosteal apposition (e.g., increases in periosteal perimeter, cortical cross-sectional thickness, and cross-sectional area). However, osteocyte densities, osteocyte lacunar dimensions, and the nanomechanical behaviour on the single mineralised collagen fibril level remained unaffected. Our correlative multiscale investigation provides structural, chemical, and nanomechanical evidence substantiating earlier reports suggesting that rats ovariectomised at 12 weeks undergo simultaneous bone loss and growth, resulting in the effects of OVX being less obvious. Periosteal apposition contradicts the conventional view of bone loss in osteoporosis but appears advantageous for the greater functional demand imposed on the skeleton by increased body weight and fragility induced by increased intracortical porosity. Through a variety of morphological changes, it is likely that 12 week old rats are able to adapt to OVX-related microstructural and compositional alterations. This article is protected by copyright. All rights reserved.
PMID: 29143443 [PubMed - as supplied by publisher]
Increased Free Testosterone Levels in Men with Uncontrolled Type 2 Diabetes Five Years After Randomization to Bariatric Surgery.
Obes Surg. 2017 Nov 15;:
Authors: Pham NH, Bena J, Bhatt DL, Kennedy L, Schauer PR, Kashyap SR
Hypogonadism frequently occurs in male patients with type 2 diabetes (T2DM) and is linked to insulin resistance and inflammation. Testosterone levels rise acutely in obese patients following bariatric surgery, though long-term changes have not been investigated in a randomized controlled trial. This study evaluated obese men with T2DM randomized to either bariatric surgery or medical therapy. Testosterone, gonadotropins, body composition, insulin sensitivity, and inflammatory markers were evaluated in 32 patients at baseline and at 5 years. Surgical patients had 47.4% increase in free testosterone compared to medical therapy patients who had 2.2% decrease (P = 0.013). Increase in free testosterone correlated with reduction in body weight, high-sensitivity C-reactive protein (hsCRP), and leptin levels. Prolonged improvements in testosterone levels after bariatric surgery in T2DM are found to be related to reduction in body weight and adipogenic inflammation.
PMID: 29143290 [PubMed - as supplied by publisher]
Translating aetiological insight into sustainable management of type 2 diabetes.
Diabetologia. 2017 Nov 15;:
Authors: Taylor R, Barnes AC
Using a low-energy diet as a tool, it has been possible to elucidate the sequence of pathophysiological changes that lead to the onset of type 2 diabetes. Negative energy balance in type 2 diabetes causes a profound fall in liver fat content resulting in normalisation of hepatic insulin sensitivity within 7 days. As the period of negative energy balance extends and liver fat levels fall to low normal, the rate of export of triacylglycerol from the liver falls. Consequent to this, the raised pancreas fat content falls and in early type 2 diabetes, normal first-phase insulin secretion becomes re-established with normal plasma glucose control. This research, driven by the predictions of the 2008 twin cycle hypothesis, has led to a paradigm shift in understanding. Studying the reversed sequence of pathophysiological changes, the linked abnormalities in liver and pancreas have been revealed. Early type 2 diabetes is a potentially reversible condition. Surprisingly, it was observed that the diet devised as an experimental tool was actually liked by research participants. It was associated neither with hunger nor tiredness in most people, but with rapidly increased wellbeing. A defined period of weight loss followed by carefully planned weight maintenance-the 'One, Two' approach-has since been applied in clinical practice. Motivated individuals can reverse their type 2 diabetes and remain normoglycaemic over years. A large study is underway to evaluate the applicability of this general approach to routine primary care practice as a long-term management strategy.
PMID: 29143063 [PubMed - as supplied by publisher]
Assessment of Severity of Malnutrition in Peritoneal Dialysis Patients via Malnutrition: Inflammatory Score.
Adv Biomed Res. 2017;6:128
Authors: Naeeni AE, Poostiyan N, Teimouri Z, Mortazavi M, Soghrati M, Poostiyan E, Paknahad Z
Background: Regarding to the complications of malnutrition in dialysis patients, using an easy and reliable method for evaluating of malnutrition is important in patients with the end-stage renal disease. Based on the effect of inflammatory factors in malnutrition, A new scale has been designed which is called malnutrition-inflammatory scale (MIS). We designed current study to assess the severity of malnutrition in peritoneal dialysis patients in Isfahan via MIS.
Materials and Methods: In this cross-sectional MIS was used for evaluation of malnutrition. MIS includes 10 components: dry weight changes, dietary intake, functional capacity, comorbidity, muscle wasting and loss of subcutaneous fat as well as body mass index (BMI), serum albumin level and total iron binding capacity (TIBC). Each component has four levels of severity from 0 (normal) to 3 (severely abnormal). All analyses were performed using Statistical Package for Social Sciences version 20 (SPSS 20) and P < 0.05 were considered statistically significant.
Results: Results showed no significant difference in MIS between male and female participants. Mean of minimum inhibitory concentration in this study was calculated about 4.1 (MIS <9) which means no or mild malnutrition. Significant correlation between MIS and weight (P < 0.001), BMI (P < 0.001), TIBC (P < 0.001), triglyseride (P = 0.04) and arm circumference (P < 0.001) was seen.
Conclusion: We suggest That MIS is being used as a valuable tool for prevention of fatal outcomes in chronic dialysis patients.
PMID: 29142891 [PubMed]
Prevention of Insulin Resistance by Dietary Intervention among Pregnant Mothers: A Randomized Controlled Trial.
Int J Prev Med. 2017;8:85
Authors: Goodarzi-Khoigani M, Mazloomy Mahmoodabad SS, Baghiani Moghadam MH, Nadjarzadeh A, Mardanian F, Fallahzadeh H, Dadkhah-Tirani A
Background: Chronic insulin resistance (IR) is a basic part of the pathophysiology of gestational diabetes mellitus. Nutrition significantly impacts IR and weight loss reduces insulin levels, whereas weight gain increases the concentrations. Therefore, we surveyed the effect of nutrition intervention on IR in pregnant women and whether this effect is irrespective of weight gaining in accordance with Institute of Medicine limits.
Methods: This prospective, randomized clinical trial was carried out among 150 primiparous pregnant mothers in fifteen health centers, five hospitals, and 15 private obstetrical offices in Isfahan. The nutrition intervention included education of healthy diet with emphasize on 50%-55% of total energy intake from carbohydrate (especially complex carbohydrates), 25%-30% from fat (to increase mono unsaturated fatty acids and decrease saturated and trans-fatty acids), and 15%-20% from protein during pregnancy for experimental group. The controls received the usual prenatal care by their health-care providers.
Results: This trial decreased pregnancy-induced insulin increases (P = 0.01) and IR marginally (P = 0.05). ANCOVA demonstrated that control of gestational weight gaining was more effective to decrease IR (P = 0.02) while insulin values decreased by nutrition intervention and irrespective of weight control (P = 0.06). Fasting plasma glucose (FPG) concentrations did not decrease by intervention (P = 0.56) or weight management (P = 0.15).
Conclusions: The current intervention was effective to decrease pregnancy-induced insulin increases and IR. Considering study results on FPG levels and incidence of GDM, we suggest repeat of study design in a larger sample.
PMID: 29142651 [PubMed]
Melatonin Supplementation Lowers Oxidative Stress and Regulates Adipokines in Obese Patients on a Calorie-Restricted Diet.
Oxid Med Cell Longev. 2017;2017:8494107
Authors: Szewczyk-Golec K, Rajewski P, Gackowski M, Mila-Kierzenkowska C, Wesołowski R, Sutkowy P, Pawłowska M, Woźniak A
Obesity is one of the major global health problems. Melatonin deficiency has been demonstrated to correlate with obesity. The aim of the study was to estimate the effect of melatonin on oxidative stress and adipokine levels in obese patients on a calorie-restricted diet. Thirty obese patients were supplemented with a daily dose of 10 mg of melatonin (n = 15) or placebo (n = 15) for 30 days with a calorie-restricted diet. Serum levels of melatonin, 4-hydroxynonenal (HNE), adiponectin, omentin-1, leptin, and resistin, as well as erythrocytic malondialdehyde (MDA) concentration and Zn/Cu-superoxide dismutase, catalase, and glutathione peroxidase (GPx) activities, were measured at baseline and after supplementation. Significant body weight reduction was observed only in the melatonin group. After melatonin supplementation, the adiponectin and omentin-1 levels and GPx activities statistically increased, whereas the MDA concentrations were reduced. In the placebo group, a significant rise in the HNE and a drop in the melatonin concentrations were found. The results show evidence of increased oxidative stress accompanying calorie restriction. Melatonin supplementation facilitated body weight reduction, improved the antioxidant defense, and regulated adipokine secretion. The findings strongly suggest that melatonin should be considered in obesity management. This trial is registered with CTRI/2017/07/009093.
PMID: 29142618 [PubMed - in process]
Primary Gastric Burkitt's lymphoma.
Pak J Med Sci. 2017 Sep-Oct;33(5):1294-1297
Authors: Khan A, Khan S, Arshad U
The primary gastrointestinal non-Hodgkin's lymphoma is a rare entity. Burkitt's lymphoma (BL) is an aggressive form of B-cell lymphoma which is endemic in Africa, while in rest of the world non-endemic cases has been reported. Primary gastric BL is extremely rare and only around 53 cases have been reported till now. Here we present the case of a middle-aged male, immunocompetent who presented with anorexia weight loss and diarrhea. His upper gastrointestinal endoscopy and biopsy revealed a large primary gastric Burkitt lymphoma. After chemotherapy, he remains in remission.
PMID: 29142583 [PubMed]
Pneumatic Balloon Dilatation for Achalasia Cardia; Early & late results, a single center study.
Pak J Med Sci. 2017 Sep-Oct;33(5):1053-1058
Authors: Shah SWH, Butt AK, Malik K, Alam A, Khan AA
Objective: Achalasia Cardia is treated by Pneumatic balloon dilatation, Heller's Myotomy and recently, by Peroral Esophagaeal Myotomy. This study reports the efficacy of pneumatic balloon dilatation as a non-surgical motility in achieving relief of dysphagia, clinical improvement and recurrence. Long-term complications were reported.
Methods: Eight hundred ninety two adult achalasia patients of both genders were treated from January 1988 till December 2011, with pneumatic balloon (Rigiflex Microvasive(®)) dilatation, under fluoroscopy Barium swallow was obtained prior to and five minutes after dilatation to evaluate for efficacy of dilatation as well as for complications. Patients not responding to 30 mm balloon had repeat dilatation with 35 mm balloon after 8 weeks. All patients were enrolled in regular follow up at one, six months and yearly intervals up to a period of five years. Recurrence was defined as an increase in symptom score at 8 weeks greater than 50% of their baseline value. These patients were treated with 35 mm balloon or referred for surgical intervention.
Results: Of 892 patients, follow up was obtained in 50% for 5 years, 9.2% for 4-years), 9.3% for 3-years, 10% for 2-years and 21.5% for 1-year of patients. One patient died after repeat dilatation. Eighty-eight patients were excluded from this analysis (20 died due to non-procedure related causes and another 68 were lost during follow up). Statistically significant improvement was noted in reduction in height and width of barium column and symptom score coupled with weight gain during follow up. Forty-eight patients were subjected to repeat dilatation with 35 mm balloon, two of these developed post-procedure perforations with one mortality. Three non-responsive patients required surgical laparoscopic myotomy. No carcinoma of esophagus was reported during follow up. One patient post dilatation, developed esophageal bezoar. A single pneumatic dilatation achieved a remission rate of 93% at four years, 90% at three years, 95% at two years and 92% at one year post dilatation.
Conclusion: Achalasia of esophagus can be effectively and safely treated with balloon dilatation to achieve adequate short and long-term symptomatic relief with a low complication rate.
PMID: 29142537 [PubMed]
A case of celiac disease with neurologic manifestations misdiagnosed as amyotrophic lateral sclerosis.
Intest Res. 2017 Oct;15(4):540-542
Authors: Ham H, Lee BI, Oh HJ, Park SH, Kim JS, Park JM, Cho YS, Choi MG
Celiac disease (CD) is an immune-mediated enteropathy and is a rare disease in Asia, including in Korea. However, the ingestion of wheat products, which can act as a precipitating factor of CD, has increased rapidly. CD is a common cause of malabsorption, but many patients can present with various atypical manifestations as first presented symptoms, including anemia, osteopenia, infertility, and neurological symptoms. Thus, making a diagnosis is challenging. We report a case of CD that mimicked amyotrophic lateral sclerosis (ALS). The patient was a sexagenary man with a history of progressive motor weakness for 2 years. He was highly suspected as having ALS. During evaluation of his neurological symptoms, esophagogastroduodenoscopy (EGD) was performed because he had experienced loose stools and weight loss for the previous 7 months. On EGD, the duodenal mucosa appeared smooth. A biopsy revealed severe lymphoplasma cell infiltration with flattened villi. His serum endomysial antibody (immunoglobulin A) titer was 1:160 (reference, <1:40). Finally, he was diagnosed as having CD, and a gluten-free diet was immediately begun. At a 4-month follow-up, his weight and the quality of his stool had improved gradually, and the neurological manifestations had not progressed.
PMID: 29142524 [PubMed]
Bioactive Turmerosaccharides from Curcuma longa Extract (NR-INF-02): Potential Ameliorating Effect on Osteoarthritis Pain.
Pharmacogn Mag. 2017 Oct;13(Suppl 3):S623-S627
Authors: Bethapudi B, Murugan S, Illuri R, Mundkinajeddu D, Velusami CC
Background: Curcuma longa has long history of medicinal use in Ayurveda. A unique product NR-INF-02 was prepared from C. longa that was standardized to contain turmerosaccharides.
Objective: The present study investigated the effect of turmerosaccharides rich fraction of NR-INF-02 on monosodium iodoacetate (MIA)-induced OA pain animal model that mimics human OA. Further, the analgesic effect of turmerosaccharides rich fraction was compared to turmerosaccharides less fraction of NR-INF-02.
Materials and Methods: OA pain was chemically induced by intra-articular administration of single dose of 25 μl of 0.9% saline containing 0.3 mg MIA into the right knee of male albino Wistar rat. Turmerosaccharides rich fraction and turmerosaccharides less fraction (at 22.5, 45 and 90 mg/kg rat body weight dose levels) were administered as a single dose orally on day 5 of post-MIA injection. OA pain was measured using hind limb weight-bearing ability at 1, 3, 6, and 24 h post-test substance administration on day 5.
Results: Oral administration of turmerosaccharides rich fraction and turmerosaccharides less fraction (at 45 and 90 mg/kg) although significantly decreased the OA pain at all the intervals, the effect of turmerosaccharides rich fraction (57%) on OA pain was superior to turmerosaccharides less fraction (35%).
Conclusion: Bioactive turmerosaccharides from C. longa extract contribute to the observed anti-arthritic effect in rats.
SUMMARY: Osteoarthritic pain was induced by intra-articular injection of MIA into the right kneeSingle administration of TRF/TLF on day 5 resulted in dose-dependent significant reduction of OA painTRF showed better analgesic activity than TLFTRF at 45 and 90 mg/kg has similar effects on OA pain as that of tramadolTurmerosaccharides identified as bioactive constituents of C. longa extract. Abbreviations used: MIA: Monosodium iodoacetate; i.ar: Intra-articular; OA: Osteoarthritis; TRF: Turmerosaccharides rich fraction; TLF: Turmerosaccharides less fraction; PGE2: Prostaglandin E2; ROS: Reactive oxygen species.
PMID: 29142423 [PubMed]
Exploring the Cytotoxic Potential of Triterpenoids-enriched Fraction of Bacopa monnieri by Implementing In vitro, In vivo, and In silico Approaches.
Pharmacogn Mag. 2017 Oct;13(Suppl 3):S595-S606
Authors: Mallick MN, Khan W, Parveen R, Ahmad S, Sadaf, Najm MZ, Ahmad I, Husain SA
Background: Bacopa monnieri (BM) is a herbaceous plant traditionally used from time immemorial in Ayurvedic and folklore medicines. We hypothesized that the extract of the whole plant might contain numerous molecules with having antitumor activities that could be very effective in killing of human cancer cells.
Objectives: This work investigated anticancer activity of bioactive fraction of BM.
Materials and Methods: The hydroalcoholic extract of BM was fractionated with different solvent, namely, hexane, dichloromethane (DCM), acetone, methanol, and water. The in vitro anticancer activity was performed against various Human Cancer Cell lines, namely, Colon (HT29, Colo320, and Caco2), Lung (A549), Cervix (HeLa, SiHa), and Breast (MCF-7, MDAMB-231). Further, DCM fraction was evaluated in vivo for anticancer activity against Ehrlich ascites carcinoma (EAC) tumor-bearing mice since it showed the best cytotoxicity at 72 h (IC50 41.0-60.0 µg/mL). The metabolic fingerprinting of these extract were carried out using high-performance thin-layer chromatography along with quantification of bacoside A, bacoside B, cucurbitacin B, cucurbitacin E, and bittulinic acid.
Results: Oral administration of DCM fraction at a dose of 40 mg/kg rendered prominent reduction of tumor regression parameters such as tumor weight, packed cell volume, tumor volume and viable tumor cell count as compared to the untreated mice of the EAC control group. The anticancer activity of DCM fraction may be due to the presence of large amount of bacoside A, B and cucurbitacins. The molecular docking studies of major metabolites with targeted proteins predicted the anticancer activity of DCM fraction which was in support of in vivo activity.
Conclusion: The in vitro, in vivo, analytical and in silico studies on DCM fraction of Bacopa monieri has proved its great potential for development of anticancer phytopharmaceuticals.
SUMMARY: A new HPTLC method has been developed and validated for the qualitative and quantitative analysis of bacoside A, B, cucurbitacin B, D, E and bittulinic acid in Bacopa monnieri extract. Enrichment of active anticancer metabolites was done by polarity based fractionations of hydroalcoholic extract of Bacopa. DCM fraction of a hydroalcoholic extract of Bacopa showed anticancer potential against human cancer cell line (IC50 41.0-60.0 µg/mL) and in EAC treated mice (at a dose of 40 mg/kg body weight). The anticancer activity of Bacopa may be due to the presence of bacosides and cucurbitacin and it was confirmed by in silico screening. Abbreviations used: DBM: DCM fraction of Bacopa monnieri; DCM: Dichloromethane; EAC: Ehrlich ascites carcinoma; HCT: Hematocrit; HGB: Hemoglobin; HPTLC: High performance thin layer chromatography; ICH: International council for Harmonisation; LOD: Limit of detection; LOQ: Limit of quantification; LYM: Lymphocytes; MCH: Mean corpuscular hemoglobin; MCHC: Mean corpuscular haemoglobin concentration (MCHC); MCV: Mean corpuscular volume; MTT: 3-(4, 5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide; PLT: Platelet; RBC: Red blood cell; RDW: Red blood cell distribution width; RSD: Relative standard deviation; WBC: White blood cells.
PMID: 29142420 [PubMed]
Biocompatibility and biodegradation studies of a commercial zinc alloy for temporary mini-implant applications.
Sci Rep. 2017 Nov 15;7(1):15605
Authors: Kannan MB, Moore C, Saptarshi S, Somasundaram S, Rahuma M, Lopata AL
In this study, the biocompatibility and in vitro degradation behaviour of a commercial zinc-based alloy (Zn-5 Al-4 Mg) were evaluated and compared with that of pure zinc for temporary orthopaedic implant applications. Biocompatibility tests were conducted using human alveolar lung epithelial cells (A549), which showed that the zinc alloy exhibits similar biocompatibility as compared to pure zinc. In vitro degradation evaluation was performed using weight loss and electrochemical methods in simulated body fluid (SBF) at 37 °C. Weight loss measurements revealed that the degradation of the zinc alloy was slightly lower during the initial immersion period (1-3 days), but marginally increased after 5 and 7 days immersion as compared to pure zinc. Potentiodynamic polarisation experiments showed that the zinc alloy exhibits higher degradation rate than pure zinc. However, electrochemical impedance spectroscopy analysis suggests that pure zinc is susceptible to localized degradation, whereas the zinc alloy exhibited passivation behaviour. Post-degradation analysis revealed localized degradation in both pure zinc and the zinc alloy.
PMID: 29142320 [PubMed - in process]
Genetic risk scores for body fat distribution attenuate weight loss in women during dietary intervention.
Int J Obes (Lond). 2017 Nov 16;:
Authors: Svendstrup M, Allin KH, Sørensen TIA, Hansen TH, Grarup N, Hansen T, Vestergaard H
BACKGROUND AND AIM: The well-established link between body fat distribution and metabolic health has been suggested to act through an impact on the remodeling capacity of the adipose tissue. Remodeling of the adipose tissue has been shown to affect body fat distribution and might affect the ability to lose weight. We aimed to study the effect of weighted genetic risk scores (GRSs) on weight loss based on single-nucleotide polymorphisms (SNPs) associated with waist-hip-ratio adjusted for body mass index (WHRadjBMI).
METHOD: We included 707 participants (533 women and 174 men) from the NUGENOB multi-center 10 week diet intervention study with weekly weight measurements. We created 3 GRSs, one including all reported WHRadjBMI SNPs (GRStotal), one including only SNPs with genome wide significance in women or with significantly greater effect in women (GRSwomen), and one excluding SNPs in the GRSwomen (GRSmen). The data was analyzed in a mixed linear model framework.
RESULTS: The GRStotal and GRSwomen attenuated weight loss in women. The effect was strongest for the GRSwomen with an effect of 2.21 g/risk allele/day [95% CI (0.90;3.52), P=0.0009]. Adjustment for WHR, basal metabolic rate or diet compliance did not affect the result. The GRSs had no effect on weight loss in men. The VEGFA rs1358980-T strongly attenuated weight loss in both men and women [β 15.95 g/risk allele/ day, (3.16;26.74), P=0.013] and [β 15.95 g/risk allele/ day, (2.58;13.53), P=0.004], respectively).
CONCLUSION: Our findings suggest that genetic variants influencing body fat distribution attenuate weight loss in women independently on the effect on WHR. The stronger effect of the GRSwomen implies heterogenic effects of the WHRadjBMI variants on weight loss. A strong effect of rs1358980-T in the VEGFA locus suggests that angiogenesis plays a role, but this needs confirmation from functional studies.International Journal of Obesity accepted article preview online, 16 November 2017. doi:10.1038/ijo.2017.279.
PMID: 29142243 [PubMed - as supplied by publisher]
Effect of Distinct Lifestyle Interventions on Mobilization of Fat Storage Pools: The CENTRAL MRI Randomized Controlled Trial.
Circulation. 2017 Nov 15;:
Authors: Gepner Y, Shelef I, Schwarzfuchs D, Zelicha H, Tene L, Yaskolka Meir A, Tsaban G, Cohen N, Bril N, Rein M, Serfaty D, Kenigsbuch S, Komy O, Wolak A, Chassidim Y, Golan R, Avni-Hassid H, Bilitzky A, Sarusi B, Goshen E, Shemesh E, Henkin Y, Stumvoll M, Blüher M, Thiery J, Ceglarek U, Rudich A, Stampfer MJ, Shai I
Background -We aimed to assess whether distinct lifestyle strategies can differentially affect specific body adipose depots. Methods -We performed an eighteen-month randomized controlled trial among 278 sedentary adults with abdominal obesity (75%) or dyslipidemia in an isolated workplace with a monitored provided lunch. Participants were randomized to iso-caloric low-fat (LF) or Mediterranean/low-carbohydrate (MED/LC) diet+28g walnuts/day with/without added moderate physical activity (PA;80% aerobic; supervised/free gym membership). Overall primary outcome was body fat re-distribution, and the main specific endpoint was visceral adipose tissue (VAT). We further followed the dynamics of different fat depots [deep/superficial subcutaneous (D/SSAT), liver, pericardial, muscle, pancreas and renal-sinus] by magnetic-resonance-imaging. Results -Of 278 participants (age=48y; 89%men, body-mass-index=30.8kg/m(2)), 86% completed the trial, with good adherence. The LF group preferentially decreased reported fat intake (-21.0% vs. -11.5% for the MED/LC; P<0.001), and the MED/LC group decreased reported carbohydrates intake (-39.5%vs. -21.3% for the LF;P<0.001). The PA(+) groups significantly increased the metabolic-equivalents (METs)/week vs. the PA(-) groups (19.0 vs. 2.1;P=0.009). Whereas final moderate weight loss was indifferent, exercise attenuated the waist circumference rebound with the greatest effect in MED/LC(PA+) group (P<0.05). VAT (-22%), intra-hepatic (-29%), and Intra-pericardial (-11%) fats declines were higher than pancreatic and femur intermuscular fats (1-2%) loss. Independent of weight loss, PA+ with either diet had a significantly greater effect on decreasing VAT [mean-of-difference=-6.67cm(2);95%CI:(-14.8 to -0.45) compared with PA(-)]. The MED/LC diet was superior to LF in decreasing intra-hepatic, intra-pericardial and pancreatic fats (P<0.05 for all). In contrast, renal-sinus and femoral-intermuscular fats were not differentially altered by lifestyle interventions, but by weight loss per-se. In multivariate models, further adjusted for weight loss, losing VAT or intra-hepatic fat were independently associated with improved lipid profile, losing deep-SAT with improved insulin sensitivity and losing superficial-SAT remained neutral except of association with decreased leptin. Conclusions -Moderate weight loss alone inadequately reflects the significant lifestyle effects on atherogenic and diabetogenic fat depots. The MED/LC diet mobilizes specific ectopic fat depots, and exercise has an independent contribution to VAT loss. Fat depots exhibit diverse responsiveness and are differentially related to cardiometabolic markers. Distinct lifestyle protocols may uniquely induce fat mobilization from specific anatomical sites. Clinical Trial Registration -URL: http://www.clinicaltrials.gov. Unique identifier: NCT01530724.
PMID: 29142011 [PubMed - as supplied by publisher]
Reversible brain lesion following growth hormone replacement therapy in an adolescent.
BMJ Case Rep. 2017 Nov 14;2017:
Authors: Hadjipanayis A, Efstathiou E, Theophilou L, Chrousos G
A 12.6-year-old girl presented with a 2-month history of headache, recurrent vomiting and 5 kg weight loss. She had been receiving recombinant human growth hormone (rhGH) replacement therapy at a dose of 0.035 mg/kg for the past 10 months, due to short stature. Investigations before initiating rhGH, including brain MRI, had been normal. Physical examination revealed a nystagmus and a mildly elevated arterial blood pressure. Brain MRI revealed a lesion in the posterior aspect of the medulla oblongata, adjacent to the foramen of Magendie. rhGH therapy was discontinued, followed by a gradual resolution of the symptoms. At follow-up 3 months later, she was asymptomatic and physical examination was unremarkable. A subsequent repeat brain MRI showed complete resolution of the lesion, supporting the diagnosis of a variant of reversible posterior leucoencephalopathy syndrome. This is the first case report of a reversible brain lesion linked to rhGH replacement therapy.
PMID: 29141928 [PubMed - in process]
A Hospital-Based Study of Intestinal Capillariasis in Thailand: Clinical Features, Potential Clues for Diagnosis, and Epidemiological Characteristics of 85 Patients.
Am J Trop Med Hyg. 2017 Oct 23;:
Authors: Sadaow L, Sanpool O, Intapan PM, Sukeepaisarnjaroen W, Prasongdee TK, Maleewong W
Intestinal capillariasis caused by Capillaria philippinensis, a fish-borne nematode, is an important, emerging zoonotic helminthiasis. Cases may be fatal if suitable treatment is not administered in time. We reported a hospital-based study of 85 cases in Thailand, most of which were in the northeast. All patients had a history of eating raw or insufficiently cooked fresh water fish or prawns. The clinical manifestations are characterized by chronic diarrhea, borborygmi, abdominal pain, marked weight loss, muscle weakness, fatigue, dizziness, anorexia, and edema, as well as protein and electrolyte loss. Fecal examination revealed C. philippinensis in all patients. Although 16 of the total of 85 (18.8%) cases were initially found to be negative for C. philippinensis using fecal examination, further examination using an immunoblotting technique found them to be positive for the IgG antibody against Trichinella spiralis larval antigen. One day after administration of 400 mg of albendazole, eggs and/or larvae and/or adult C. philippinensis were found in 16 fecal samples. After treatment with mebendazole (200 mg twice a day for 30 days) or albendazole (200 mg twice a day for 10 days), all 85 patients recovered. The potential clues for diagnosis are clinical manifestations, history of eating raw contaminated food, and positive serological test, and fecal examinations under professional. Administration of anthelminthic drugs stimulates the excretion of larvae, eggs, and/or adult worms and can be used as a supportive method for the diagnosis of intestinal capillariasis in areas where serological test is not available.
PMID: 29141741 [PubMed - as supplied by publisher]
[Effect of recombinant human growth hormone therapy on metabolic parameters in patients with craniopharyngioma].
Zhonghua Yi Xue Za Zhi. 2017 Nov 14;97(42):3286-3290
Authors: Mao JF, Wang X, Xiong SY, Zheng JJ, Yu BQ, Nie M, Wu XY, Qi ST
Objective: To investigate the effects of recombinant human growth hormone (rhGH) on metabolic parameters in patients with craniopharyngioma surgeries. Methods: Totallys 30 patients with craniopharyngioma were included in this retrospective study. They were divided into growth hormone (GH) group and control group according to whether they received rhGH therapy or not. The following parameters, including body mass index (BMI), weight, waist circumstance, transaminase, fasting blood glucose, lipid profile and high-sensitivity C-reactive protein (hsCRP) were compared after rhGH therapy for 4-6 months. Results: In GH group, patients were 18-46 (30.0±8.8) years old. The duration after craniopharyngioma surgery was (12.9±5.4) years. Before rhGH therapy, they had got sufficient thyroid and glucocorticoid hormone replacement. After rhGH therapy, the body weight decreased from (92.3±20.1) to (87.6 ±14.6) kg (P=0.190), with a reduction of BMI from (30.1±5.9) to (28.2±3.7) kg/m(2) (P=0.120). The waist circumference decreased from (104.4±9.4) cm to (98.8±10.6) cm (P=0.002). Alanine aminotransferase (ALT) decreased from (52±34) to (28±19) U/L (P=0.029), with a reduction of aspartate transaminase (AST) from (46±21) to (33±18) U/L (P=0.035) and γ-glutamyl transpeptadase (GGT) from (59±42) to (29±15) U/L (P=0.02). hsCRP decreased from (5.3±4.9) to (2.3±2.8) mg/L (P=0.006) and triglyceride (TG) decreased from (1.8±0.7) to (1.5±0.6) mmol/L (P=0.028). Fasting blood glucose, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and free fat acid (FFA) were not significantly changed(all P>0.05). In the control group, the above mentioned parameters did not changed significantly during 4-6 months of observational period(all P>0.05). Conclusion: rhGH therapy improves metabolic parameters in patients after craniopharyngioma surgery by decreasing body weight, waist circumstance and fat deposit in liver, as well as lowering TG and hsCRP levels.
PMID: 29141371 [PubMed - in process]
Evaluation of Temporal Virological Responses to Interferon-α-2b plus Ribavirin among Genotype 3a Hepatitis C Virus-Infected Patients.
Intervirology. 2017 Nov 16;:
Authors: Raza A, Ovais M, Aziz H, Anwar A, Irfan J, Ahmad I, Mukhtar M
OBJECTIVES: The present study aimed to examine the impact of rapid virological response (RVR) and early virological response (EVR) on sustained virological response (SVR) in chronic hepatitis C genotype 3a individuals.
METHODS: The patients were given antiviral therapy with IFN-α-2b, 3 million units 3 times a week and 800-1,200 mg of ribavirin daily adjusted to the patient's body weight (<60 kg 800 mg day-1, and >60 kg 1,200 day-1). The patients received this combination therapy for 24 weeks. The patients were evaluated for their viral load at week 4, 12, and 24 using RT-PCR.
RESULTS: Out of 1,471 patients, 43.3% showed a negative viral load in week 4, demonstrating RVR, whereas 56.6% maintained a high viral load. These were further separated based on viral reduction in their plasma: either negative for HCV-RNA at week 12 (n = 575), manifesting EVR, or showing a 2-log reduction in HCV viral load classified as partial EVR (PEVR; n = 259). The PEVR response was less (29.7%) compared with RVR (85.9%) and EVR (69.0%), although nonresponders were found in both groups.
CONCLUSIONS: Individuals incompliant with their treatment who have a higher RVR significantly influence their SVR towards a better remission that can be treated within a short duration with standard treatment.
PMID: 29141246 [PubMed - as supplied by publisher]
Neutrophil Mediated Suppression of Influenza-induced Pathology Requires CD11b/CD18 (MAC-1).
Am J Respir Cell Mol Biol. 2017 Nov 15;:
Authors: Tak T, Rygiel TP, Karnam G, Bastian OW, Boon L, Viveen M, Coenjaerts FE, Meyaard L, Koenderman L, Pillay J
Severe influenza virus infection can lead to life-threatening pathology through immune-mediated tissue damage. In various experimental models, this damage is dependent on T-cells. There is conflicting evidence regarding the role of neutrophils in influenza-mediated pathology. Neutrophils are often regarded as cells causing tissue damage, but in recent years it has become clear that a subset of human neutrophils is capable of suppressing T-cells, which is dependent on Mac-1 (CD11b/CD18). Therefore, we tested the hypothesis that immune suppression by neutrophils can reduce T-cell mediate pathology after influenza infection. Wild type (WT) and CD11b-/- mice were infected with A/HK/2/68 (H3N2) influenza virus. Disease severity was monitored by weight-loss, leukocyte infiltration and immunohistochemistry. We demonstrated that CD11b-/- mice suffered increased weight-loss compared to WT animals upon infection with influenza virus. This was accompanied by increased pulmonary leukocyte infiltration and lung damage. The exaggerated pathology in CD11b-/- mice was dependent on T-cells as it was reduced by T-cell depletion. In addition, pathology in CD11b-/- mice was accompanied by higher numbers of T-cells in the lungs early during infection compared to WT mice. Importantly, these differences in pathology were not associated with an increased viral load, suggesting that pathology was immune-mediated rather than caused by virus-induced damage. In contrast to adoptive transfer of CD11b-/- neutrophils, a single adoptive transfer of WT neutrophils partly restored protection against influenza-induced pathology, demonstrating the importance of neutrophil CD11b/CD18. Our data show that neutrophil CD11b/CD18 limits pathology in influenza-induced, T-cell mediated disease.
PMID: 29141155 [PubMed - as supplied by publisher]
Limb Segment Load Inhibits the Recovery of Soleus H-Reflex After Segmental Vibration in Humans.
J Mot Behav. 2017 Nov 15;:1-12
Authors: Tseng SC, Shields RK
We investigated the effects of vertical vibration and compressive load on soleus H-reflex amplitude and postactivation depression. We hypothesized that, in the presence of a compressive load, limb vibration induces a longer suppression of soleus H-reflex. Eleven healthy adults received vibratory stimulation at a fixed frequency (30 Hz) over two loading conditions (0% and 50% of individual's body weight). H-reflex amplitude was depressed ∼88% in both conditions during vibration. Cyclic application of compression after cessation of the vibration caused a persistent reduction in H-reflex excitability and postactivation depression for > 2.5 min. A combination of limb segment vibration and compression may offer a nonpharmacologic method to modulate spinal reflex excitability in people after CNS injury.
PMID: 29140761 [PubMed - as supplied by publisher]
Optimizing the electrical conductivity of marinade solution for water-holding capacity of broiler breast meat.
Poult Sci. 2017 Nov 11;:
Authors: Kaewthong P, Wattanachant S
This study explored the possibility of forecasting the performance of marinade solutions in improving the water-holding capacity (WHC; weight gain, drip loss, cooking loss, and total yield) of marinated broiler breast meat based upon the electrical conductivity (EC) of the marinade solution. Normal- (50 ≤ L* ≤ 56) and light-colored samples (L* > 56), obtained from a production line, were marinated with 1 to 6% sodium bicarbonate (NaHCO3), 0.5 to 3% sodium tripolyphosphate (STPP), 1 to 6% sodium chloride (NaCl), and 0.05 to 0.5% acetic acid (CH3COOH) solutions. EC of all solutions increased with increasing solute concentration, and high EC of any salt solution correlated with increased weight gain and decreased drip loss and cooking loss, leading to increased total yield. CH3COOH had the least effect on the WHC of marinated breast meat. The effect of increasing EC of marinade solutions on drip loss was similar in the light- and normal-colored samples, but light-colored samples consistently had higher cooking losses and lower total yields compared with the normal-colored samples. At the same EC, NaHCO3 and STPP solutions had greater abilities to improve the total yield of marinated breast meat than the NaCl solution. Therefore, the WHC of the sample did not depend on the EC of the solution alone. However, increasing EC had a high correlation with gains in WHC of marinated breast meat for all marinade solutions (r > 0.96 for total yield). The total yield of both normal- and light-colored samples of broiler breast meat could be improved to a value higher than 75% when samples were marinated in salt solutions with EC ≥ 8.79 mS/cm for NaHCO3 or ≥ 9.91 mS/cm for STPP. NaCl solutions with EC ≥70.08 and ≥44.58 mS/cm could be used to improve total yield to values higher than 75% for light- and normal-colored samples, respectively. Our results revealed that EC could be used to forecast the performance of marinade solution in improving the WHC of marinated breast meat.
PMID: 29140471 [PubMed - as supplied by publisher]
Short-chain arabinoxylans prepared from enzymatically treated wheat grain exert prebiotic effects during the broiler starter period.
Poult Sci. 2017 Nov 10;:
Authors: Yacoubi N, Saulnier L, Bonnin E, Devillard E, Eeckhaut V, Rhayat L, Ducatelle R, Van Immerseel F
Carbohydrate-degrading multi-enzyme preparations (MEP) are used to improve broiler performances. Their mode of action is complex and not fully understood. In this study, we compared the effect of water-soluble fractions isolated at the pilot scale from wheat grain incubated with (WE) and without (WC) MEP. The fractions were incorporated in a wheat-based diet (0.1% w/w) to feed Ross PM3 broilers and compared with a non-supplemented control group (NC). The body weight gain (BWG), feed intake (FI), and feed conversion ratio (FCR) until d 14 were determined. At d 14, ileal and cecal contents and tissue samples were collected from euthanized animals. The intestinal contents were used to measure the short-chain fatty acids (SCFA) concentration using gas chromatography and to determine the abundance and composition of microbiota using 16S sequencing. Villi length of ileal samples was measured, while L-cell and T-cell densities were determined using immuno-histochemistry. The MEP treatment increased the amount of water-soluble arabinoxylans (AX) and reduced their molecular weight while retaining their polymer behavior. The WE fraction significantly (P < 0.05) increased FI by 13.8% and BWG by 14.7% during the first wk post hatch when compared to NC. No significant effect on FCR was recorded during the trial. The WE increased the abundance of Enterococcus durans and Candidatus arthromitus in the ileum and of bacteria within the Lachnospiraceae and Ruminococcaceae families, containing abundant butyrate-producing bacteria, in the ceca. It also increased the concentration of SCFA in the ceca, decreased the T-lymphocyte infiltration in the intestinal mucosa, and increased the glucagon-like-peptide-2 (GLP-2)-producing L-cell density in the ileal epithelium compared with WC and NC. No significant effects were observed on villi length. These results showed that AX present in the WE fraction altered the microbiota composition towards butyrate producers in the ceca. Butyrate may be responsible for the reduction of inflammation, as suggested by the decrease in T-lymphocyte infiltration, which may explain the higher feed intake leading to improved animal growth.
PMID: 29140465 [PubMed - as supplied by publisher]
IL-27/IL-27receptor signaling provides protection in Clostridium difficile-induced colitis.
J Infect Dis. 2017 Nov 11;:
Authors: Wang L, Cao J, Li C, Liping Z
Background: Clostridium difficile is a leading cause of nosocomial infection. The role of cytokine IL-27 in the immunopathology of Clostridium difficile infection (CDI) remains unknown.
Methods: The production of IL-27 was determined in human and murine CDI. Furthermore, wild-type (WT) and IL-27 receptor-deficient (WSX-1 -/-) mice were treated with an antibiotic mixture and infected with C.difficile to investigate the effects of IL-27 on host response to CDI.
Results: IL-27 production was elevated during CDI in humans and mice. Infected WSX-1 -/- mice experienced increased weight loss, enhanced colonic histology damage, less C.difficile clearance and decreased survival compared to WT controls during CDI. IL-27 administration reduced CDI-associated mortality and tissue pathology with improved C.difficile clearance in WT mice after C.difficile challenge. Mechanistically, IL-27-mediated host defense against CDI was associated with down-regulation of IL-17A and IL-23, but up-regulation of IL-10 and IFN-γ during CDI.
Conclusions: Our data suggest a previously unrecognized role for IL-27 in the pathogenesis of CDI, potentially providing new insight for IL-27-mediated protection against C. difficile-induced pathology.
PMID: 29140433 [PubMed - as supplied by publisher]
The Prevalence of Dietary Supplement Use among College Students: A Nationwide Survey in Japan.
Nutrients. 2017 Nov 15;9(11):
Authors: Kobayashi E, Sato Y, Umegaki K, Chiba T
To clarify the prevalence of dietary supplement use among college students, we conducted Internet-based nationwide questionnaire surveys with 157,595 Japanese college students aged between 18 to 24 years old who were registrants of Macromill Inc. (Tokyo, Japan). Among the 9066 respondents (response rate 5.8%), 16.8% were currently using dietary supplements. The prevalence of dietary supplement use did not differ significantly between males (17.1%) and females (16.7%). However, it increased according to their grade (13.1% to 20.5%), and it was higher in medical and pharmaceutical college students (22.0%) compared to others (16.7%). The main purpose of dietary supplement use was for the health benefits in both males and females. Other reasons were to build muscle in males, and as a beauty supplement and for weight loss in females. According to the purpose of dietary supplement use, the most commonly-used dietary supplements were vitamin/mineral supplements in both males and females, then protein and weight loss supplements in males and females, respectively. Although most students obtained information about dietary supplements via the Internet, they typically purchased the supplements from drug stores. Of the students surveyed, 7.5% who were currently using or used to use dietary supplements experienced adverse effects, with no significant difference between genders (8.8% in male, 7.0% in female). In conclusion, the prevalence of dietary supplement use increased with grade among college students in Japan. Some of them experienced adverse effects. Education may be important to prevent adverse effects resulting from supplement use in college.
PMID: 29140269 [PubMed - in process]
Awareness and Attitude towards Use of Dietary Supplements and the Perceived Outcomes Among Saudi Adult Male Members of Fitness Centers in Saudi Arabia.
Int J Sport Nutr Exerc Metab. 2017 Nov 15;:1-22
Authors: Alfawaz HA, Krishnaswamy S, Al-Faifi L, Atta HAB, Al-Shayaa M, Alghanim SA, Al-Daghri NM
Dietary supplements are believed to enhance athletic performance and/or prevent/reverse pathological states. Despite the increasing use of dietary supplements in Saudi Arabia, systematic studies in this field are lacking. This study aims to assess the relation between demographic and social characteristics and dietary supplement use among adult males in Saudi Arabia. Demographic and dietary supplements data from fitness club participants were collected through a questionnaire and Pearson Chi-square test was used to determine associations. A total of 448 apparently healthy adult males above 20 years of age, who were registered at fitness centers located in Saudi Arabia participated in the study. Majority [275 (62%)] of the study participants were younger (20-30 years), of normal weight [189 (43%)], without health problems [332 (79%)] and obtained an undergraduate degree or higher [336 (77%)]. Majority (58%) took supplements under the supervision of a professional and the rest depended on internet (22%), friends (12%) or books (4%) for choosing supplement types. The main motives of the participants for visiting the fitness center were: weight loss [N=149(35%)], keeping fit [N=101(24%)] and muscle building [N=151(35%)]. One hundred fifty-five participants (44%) were taking supplements on a daily basis with 34 (10%) having taken it for a prolonged duration (>1 year). The most commonly used supplements were proteins (29%) and multivitamins (21%). Supplement use was not associated with the participants' family income or level of education, but, was positively associated with younger age (<31 years) [χ(2)(2, N= 443) = 4.96, p=0.03.
PMID: 29140146 [PubMed - as supplied by publisher]
Comparison of Radiation Dose and Image Quality of Abdominopelvic CT Using Iterative (AIDR 3D) and Conventional Reconstructions.
AJR Am J Roentgenol. 2017 Nov 15;:1-7
Authors: Mello-Amoedo CD, Martins AN, Tachibana A, Pinho DF, Baroni RH
OBJECTIVE: The purpose of this study is to compare radiation dose and image quality of abdominopelvic CT studies reconstructed with iterative and conventional techniques.
MATERIALS AND METHODS: This retrospective study enrolled 99 patients who underwent abdominopelvic CT examinations with the portal venous phase images reconstructed with both filtered back projection and Adaptive Iterative Dose Reduction 3D (AIDR 3D) at different time points. Subjective assessment of image quality was performed by two radiologists who scored axial images for overall quality, sharpness, noise, and acceptability in a blinded fashion. The SD of the mean attenuation of the liver, aorta, and paraspinal muscle (as a measurement of image noise) and contrast-to-noise and signal-to-noise ratios for liver and aorta were used as objective parameters of image quality. Radiation dose parameters included CT dose index volume (CTDIvol), dose-length product, effective dose (ED), and size-specific dose estimate (SSDE). Results were compared for different body mass index (BMI; weight in kilograms divided by the square of height in meters) categories. Paired t test and McNemar paired tests for noninferiority were used, with p < 0.05 considered statistically significant.
RESULTS: We obtained a 62.5% mean reduction in CTDIvol, a 58% mean reduction in ED, and a 63% mean reduction in SSDE when AIDR 3D was used (p < 0.001). Subjective parameters of image quality were considered noninferior for AIDR 3D studies compared with filtered back projection (p < 0.001), except for the sharpness of images of patients with BMI 20-24.9. Variable results were found regarding objective assessment of image quality.
CONCLUSION: AIDR 3D allowed a significant reduction in radiation dose of abdominopelvic CT examinations without a loss of image quality in general.
PMID: 29140117 [PubMed - as supplied by publisher]
The Risk for Fall and Functional Dependence in Polish Adults 60–87 Years Old.
Coll Antropol. 2017 Mar;41(1):81-7
Authors: Domaradzki J, Koziel S, Ignasiak Z, Sławińska T, Skrzek A, Kołodziej M
The constantly rising percentage of the elderly (60+), who are particularly at risk of the dangerous consequence of falls,
results not only in the loss of independence in daily life, but also in a serious threat to health and life. Therefore, many
authors emphasize the necessity of conducting prophylaxis and prevention among senior citizens. The most important
aspect of fall prophylaxis is care about the optimum level of agility. Exercise should focus on increasing muscular strength,
balance and dexterity. The aim of the present study is to determine the relationship between functional fitness and the
risk for falls of older people in the light of maintaining physical independence. The research group consisted of 522 persons:
142 males and 380 females aged 60-84 years from Wroclaw (a city in the south-west of Poland). All subjects provided
written consent, and were measured and tested in 2009 through 2015, excluding the winter months. Body height and
weight were measured. Body mass index was calculated. The Senior Fitness Test was used to assess functional capacity
and efficiency. The results of the Senior Fitness Test were used to estimate Maintaining Physical Independence in Older
Adults. The differences in the means of the results of all the tests between the age and sex-specific groups were assessed
by means of a two-way analysis of variance, where sex and age were factors and results of appropriate test dependent
variables. Logistic regression was used to estimate the risk for fall, based on the incidence of fall in the last year, for each
test comparing the individuals met referenced criteria to maintain functionally dependence and independent, controlled
for age and BMI. The risk for falls was more than twice greater in the case of the studied females, whose muscular strength
of the upper part of the body was lower. The females in whose cases no fewer than two tests failed to ascertain functional
independence, had a greater risk for falls. In the case of the males, no statistically-significant connections between functional
independence and the risk for falls was found.
PMID: 29139651 [PubMed - in process]
SiC Nanofiber Mat: A Broadband Microwave Absorber and the Alignment Effect.
ACS Appl Mater Interfaces. 2017 Nov 15;:
Authors: Hou Y, Cheng L, Zhang Y, Yang Y, Deng C, Yang Z, Chen Q, Du X, Zheng L
Fiber alignment is a key factor that determines the physical properties of nanofiber mats. In this work, SiC nanofiber mats with or without fiber alignment are fabricated via electrospinning and the microwave electromagnetic (EM) properties of their silicone resin composites (5wt.%) are investigated in 2-18 GHz. By comparing with the composite containing smashed nanofiber, it is found that the nanofiber mats show superior dielectric loss and a minimal reflection loss (RL) of around -49 dB at 8.6 GHz and 4.3 mm thickness, associated with a broad effective absorption (<-10 dB) bandwidth (EAB) of about 7.2 GHz at 2.8 mm thickness. Moreover, the performance can be further enhanced (RL= -53 dB at 17.6 GHz and 2.3 mm thickness) by aligning the nanofiber in the plane of mat, accompanied by the shift of absorption peak to higher frequency direction with broadening of EAB to 8.6 GHz at around 3mm. In addition, the way of mats stacking (ether parallel or perpendicular) would have negligible effect on the microwave properties of mat composite. Compared with parallel-stacking of the aligned mats, cross-stacking (perpendicular) only leads to slightly drop of the attenuation ability. It confirms that alignment offers a more effective approach to improve the microwave absorption properties of the SiC nanofiber mats than changing the way of mat stacking. Furthermore, it is worth mentioning that the low loading fraction (5 wt.%) is a great advantage to reduce the weight and the cost for large scale production. All these facts indicate that the aligned SiC nanofiber mats can be a great light-weight and broadband microwave absorber.
PMID: 29139298 [PubMed - as supplied by publisher]
Tailor management to the patient with fibroids.
Practitioner. 2017 Mar;261(1802):19-22
Authors: O'Sullivan M, Overton C
Fibroids are benign, hormone-dependent tumours of uterine smooth muscle and connective tissue. They are commonly asymptomatic, but can cause symptoms such as heavy menstrual bleeding and pelvic pressure symptoms. Between 20 to 30% of women with heavy menstrual bleeding have fibroids. Fibroids are most prevalent in women aged 30-50 years and there may be a genetic predisposition. They are more common in black women than white women. Other risk factors include obesity and nulliparity. Asymptomatic women should only be referred if their uterus is palpable abdominally, if fibroids distort the uterine cavity or the uterus is larger than 12 cm in length. Symptomatic women should be referred when heavy menstrual bleeding has not responded to medical treatment, if large fibroids are causing pressure symptoms or when fibroids are associated with fertility or obstetric problems. Malignant change (leiomyosarcoma) is rare in premenopausal women. Fast track referral is indicated for women with rapid onset and progressive symptoms or rapidly enlarging fibroids, as these symptoms are suspicious of leiomyosarcoma; postmenopausal women presenting with enlarging fibroids or vaginal bleeding; and women with fibroids with any other features of cancer e.g. abnormal bleeding or weight loss.
PMID: 29139277 [PubMed - in process]
Chronic Diarrhea in Common Variable Immunodeficiency: a Case Series and Review of the Literature.
J Clin Immunol. 2017 Nov 14;:
Authors: Pecoraro A, Nappi L, Crescenzi L, D'Armiento FP, Genovese A, Spadaro G
Common variable immunodeficiency (CVID) is a primary immunodeficiency characterized by reduced immunoglobulin serum levels and absent or impaired antibody production. Clinical manifestations, including infections, inflammatory and autoimmune diseases, and malignancies, also involve various segments of the gastrointestinal tract. Chronic diarrhea is one of the most common gastrointestinal symptoms and may cause a wide spectrum of potentially life-threatening conditions as malabsorption and protein-energy malnutrition. We describe three female CVID adult patients presenting with chronic diarrhea, weight loss, and protein-energy malnutrition due to different underlying conditions. Our review of the literature explores the various gastrointestinal involvements in CVID and points out several histopathological findings proper of the disease, thus highlighting the relevance of the endoscopic and histological assessment in CVID patients presenting with chronic diarrhea.
PMID: 29138951 [PubMed - as supplied by publisher]
INSIG2 rs7566605 single nucleotide variant and global DNA methylation index levels are associated with weight loss in a personalized weight reduction program.
Mol Med Rep. 2017 Nov 14;:
Authors: Pirini F, Rodriguez-Torres S, Ayandibu BG, Orera-Clemente M, Gonzalez-de la Vega A, Lawson F, Thorpe RJ, Sidransky D, Guerrero-Preston R
Single nucleotide polymorphisms associated with lipid metabolism and energy balance are implicated in the weight loss response caused by nutritional interventions. Diet‑induced weight loss is also associated with differential global DNA methylation. DNA methylation has been proposed as a predictive biomarker for weight loss response. Personalized biomarkers for successful weight loss may inform clinical decisions when deciding between behavioral and surgical weight loss interventions. The aim of the present study was to investigate the association between global DNA methylation, genetic variants associated with energy balance and lipid metabolism, and weight loss following a non‑surgical weight loss regimen. The present study included 105 obese participants that were enrolled in a personalized weight loss program based on their allelic composition of the following five energy balance and lipid metabolism‑associated loci: Near insulin‑induced gene 2 (INSIG2); melanocortin 4 receptor; adrenoceptor β2; apolipoprotein A5; and G‑protein subunit β3. The present study investigated the association between a global DNA methylation index (GDMI), the allelic composition of the five energy balance and lipid metabolism‑associated loci, and weight loss during a 12 month program, after controlling for age, sex and body mass index (BMI). The results demonstrated a significant association between the GDMI and near INSIG2 locus, after adjusting for BMI and weight loss, and significant trends were observed when stratifying by gender. In conclusion, a combination of genetic and epigenetic biomarkers may be used to design personalized weight loss interventions, enabling adherence and ensuring improved outcomes for obesity treatment programs. Precision weight loss programs designed based on molecular information may enable the creation of personalized interventions for patients, that use genomic biomarkers for treatment design and for treatment adherence monitoring, thus improving response to treatment.
PMID: 29138870 [PubMed - as supplied by publisher]
Therapeutic effect of ulinastatin on pulmonary fibrosis via downregulation of TGF‑β1, TNF‑α and NF‑κB.
Mol Med Rep. 2017 Nov 14;:
Authors: Li D, Ji H, Zhao B, Xu C, Xia W, Han L, Yu D, Ju Y, Jin C
Pulmonary fibrosis is a chronic, progressive, lethal lung disease characterized by alveolar cell necrosis and dysplasia of interstitial fibrotic tissue, resulting in loss of lung function and eventual respiratory failure. Previously, glucocorticoid drugs were used to treat this lung disorder. However, positive responses were recorded in less than half of treated patients and the cytotoxicity caused by high dosage treatment is still a concern. The present study investigated whether ulinastatin, a typical urinary trypsin inhibitor that mitigates numerous inflammatory responses, could be a treatment option for lung fibrosis. The results demonstrated that ulinastatin had the ability to ameliorate interstitial fibrosis and alveolar exudates and to protect against lung diseases induced by smoke, irradiation or silica particles. The mechanism of ulinastatin resulted in the downregulation of inflammatory cascades: Transforming growth factor‑β1, tumor necrosis factor‑α and nuclear factor‑κB, as demonstrated by western blotting and ELISA. Ulinastatin treatment with a high dose (100,000 U/kg body weight/day) resulted in an attenuated inflammatory response, and inhibited fibrosis formation in lungs, suggesting that ulinastatin may become a part of a clinical therapeutic strategy.
PMID: 29138863 [PubMed - as supplied by publisher]
Reduced triglyceride accumulation due to overactivation of farnesoid X receptor signaling contributes to impaired liver regeneration following 50% hepatectomy in extra‑cholestatic liver tissue.
Mol Med Rep. 2017 Nov 10;:
Authors: Jia WJ, Sun SQ, Huang LS, Tang QL, Qiu YD, Mao L
The aim of the present study was to investigate the role of triglyceride metabolism in the effect of obstructive cholestasis on liver regeneration following 50% partial hepatectomy (PH). Obstructive cholestatic rat models were achieved via ligation of the common bile duct (BDL). Following comparisons between hepatic pathological alterations with patients with perihilar cholangiocarcinoma, rats in the 7 day post‑BDL group were selected as the BDL model for subsequent experiments. Liver weight restoration, proliferating cell nuclear antigen labeling index, cytokine and growth factor expression levels, and hepatic triglyceride content were evaluated to analyze liver regeneration post‑PH within BDL and control group rats. The results of the present study revealed that obstructive cholestasis impaired liver mass restoration, which occurred via inhibition of early stage hepatocyte proliferation. In addition, reduced triglyceride content and inhibited expression of fatty acid β‑oxidation‑associated genes, peroxisome proliferator activated receptor α and carnitine palmitoyltransferase, were associated with an insufficient energy supply within the BDL group post‑PH. Notably, the expression levels of fatty acid synthesis‑associated genes, including sterol‑regulatory element‑binding protein‑1c, acetyl‑coA carboxylase 1 and fatty acid synthase were also reduced within the BDL group, which accounted for the reduced triglyceride content and fatty acid utilization. Further investigation revealed that overactivated farnesoid X receptor (FXR) signaling may inhibit fatty acid synthesis within BDL group rats. Collectively, the role of triglycerides in liver regeneration following PH in extra‑cholestatic livers was identified in the present study. Additionally, the results indicated that overactivated FXR signaling‑induced triglyceride reduction is associated with insufficient energy supply and therefore contributes to the extent of impairment of liver regeneration following PH within extra‑cholestatic livers.
PMID: 29138817 [PubMed - as supplied by publisher]
A new heteropolysaccharide from the seed husks of Plantago asiatica L. with its thermal and antioxidant properties.
Food Funct. 2017 Nov 15;:
Authors: Niu Y, Li N, Alaxi S, Huang G, Chen L, Feng Z
A new heteropolysaccharide (PMH) with a molecular weight of 1.4 × 10(3) kDa was isolated from the seed husks of Plantago asiatica L. The monosaccharide composition of PMH was determined as glucose, xylose, arabinose, rhamnose, galactose and galacturonic acid with a molar ratio of 1.0 : 1.8 : 2.4 : 3.8 : 4.9 : 8.5. The backbone of PMH consisted of 1,4-β-d-GalpA with the side chains mainly composed of 1,3-α-d-Galp and 1,2-α-d-Galp which were attached to the O-3 of GlapA. The thermal analysis using the Flynn-Wall-Ozawa (FWO) method revealed that PMH had an apparent activation energy (Ea) of 173.1 kJ mol(-1). PMH experienced a major decomposition during the heating process at a temperature of 91.1 °C with a dry weight loss of 31.1%. Moreover, PMH exhibited stronger antioxidant ability than commercial psyllium, partially due to its higher content of uronic acid. The results suggested that PMH could be used in functional foods due to its structural, thermal and antioxidant characteristics.
PMID: 29138791 [PubMed - as supplied by publisher]
Renal adenocarcinoma-associated erythrocytosis in a cat: clinicopathological features and immunohistochemical results.
Open Vet J. 2017;7(4):294-299
Authors: Troia R, Agnoli C, Fracassi F, Bettini G, Sfacteria A, Pisoni L, Dondi F
This report documents a case of secondary inappropriate erythrocytosis in a cat with renal cell adenocarcinoma, its stabilization through manual erythrocytapheresis, and the EPO-immunostaining on the affected kidney. An 11-year-old cat was presented with lethargy, weight loss and polyuria/polydipsia. An abdominal mass was detected upon physical examination. Clinicopathological work-up revealed marked erythrocytosis (HCT value 64.8%), renal azotemia and decreased urine specific gravity (USG). An abdominal ultrasound was performed, localizing the mass in the right kidney. Serum erythropoietin (EPO) was above the reference interval (RI), and the cytology of the mass was indicative of renal carcinoma. Manual erythrocytapheresis was performed in order to stabilize the patient before surgery, improving the cat's clinical and clinicopathological condition. After nephrectomy, EPO and creatinine concentrations returned within the RI, while the USG markedly increased. Histopathology confirmed the diagnosis of renal adenocarcinoma. Immunohistochemistry with anti-EPO antibody revealed diffuse and strong cytoplasmatic positivity in tumor cells.
PMID: 29138743 [PubMed]
Jejunojejunal Intussusception due to Metastatic Melanoma Seven Years after the Primer.
Case Rep Surg. 2017;2017:1237510
Authors: Giakoustidis A, Goulopoulos T, Boutis A, Kavvadias G, Kainantidis A, Zaraboukas T, Giakoustidis D
Intestinal intussusception in adults is a rare medical condition accounting for less than 5% of all intussusceptions. Herein we present a 45-year-old patient with a history of abdominal pain and loss of weight. CT scan revealed jejunojejunal intussusceptions. The patient was subjected to exploratory operation and small intestine resection due to a mass causing intestinal intussusception. Pathology confirmed suspected diagnosis of metastatic melanoma to small intestine secondary to melanoma, 7 years after the initial manifestation. Postoperative evaluation with 18FDG-PET/CT revealed increased uptake in the thyroid gland. Subsequent total thyroidectomy revealed severe Hashimoto thyroiditis and no signs of metastasis. The patient received adjuvant immunotherapy and is healthy with no signs of recurrence 3 years after the initial diagnosis and treatment.
PMID: 29138707 [PubMed]
Simvastatin Ameliorates Diabetic Cardiomyopathy by Attenuating Oxidative Stress and Inflammation in Rats.
Oxid Med Cell Longev. 2017;2017:1092015
Authors: Al-Rasheed NM, Al-Rasheed NM, Hasan IH, Al-Amin MA, Al-Ajmi HN, Mohamad RA, Mahmoud AM
Simvastatin is a lipid-lowering agent used to treat hypercholesterolemia and to reduce the risk of heart disease. This study scrutinized the beneficial effects of simvastatin on experimental diabetic cardiomyopathy (DCM), pointing to the role of hyperglycemia-induced oxidative stress and inflammation. Diabetes was induced by intraperitoneal injection of streptozotocin and both control and diabetic rats received simvastatin for 90 days. Diabetic rats showed significant cardiac hypertrophy, body weight loss, hyperglycemia, and hyperlipidemia. Serum creatine kinase MB (CK-MB) and troponin I showed a significant increase in diabetic rats. Simvastatin significantly improved body weight, attenuated hyperglycemia and hyperlipidemia, and ameliorated CK-MB and troponin I. Simvastatin prevented histological alterations and deposition of collagen in the heart of diabetic animals. Lipid peroxidation and nitric oxide were increased in the heart of diabetic rats whereas antioxidant defenses were decreased. These alterations were significantly reversed by simvastatin. In addition, simvastatin decreased serum inflammatory mediators and expression of NF-κB in the diabetic heart. Cardiac caspase-3 was increased in the diabetic heart and decreased following treatment with simvastatin. In conclusion, our results suggest that simvastatin alleviates DCM by attenuating hyperglycemia/hyperlipidemia-induced oxidative stress, inflammation, and apoptosis.
PMID: 29138670 [PubMed - in process]
[Hyperthyroidism in children at the University Hospital in Dakar (Senegal)].
Pan Afr Med J. 2017;28:10
Authors: Boiro D, Diédhiou D, Niang B, Sow D, Mbodj M, Sarr A, Ndongo AA, Thiongane A, Guèye M, Thiam L, Seck N, Dieng YJ, Ba A, Ba ID, Diallo IM, Ndiaye O, Diop SN
Introduction: Hyperthyroidism in children is rare and constitutes a problem because of its psychosomatic impact. This study aimed to present an overview of the state of knowledge on these aspects in children from Dakar.
Methods: We conducted a multicenter, descriptive study over a period of 15 years. We evaluated the epidemiological, clinical and etiologic aspects of hyperthyroidism in children.
Results: 239 patients were included in the study with a prevalence of 2.4%, a sex ratio (M/F) of 0.36 and an average age of 10.8 years. The inclusion criteria were being the eldest son in a family(26.3%), being advanced (36.9%) or delayed (12.5%) in maturation, having short stature (40.1%). It was caused by Graves' disease in 90.3% of cases with psychoaffective factor in 22.1%. On a clinical point of view tachycardia (92.4%), goiter (91.1%), exophthalmia (81.8%), weight loss (69.8%) prevailed but with bed-wetting (30.2%) and psychic manifestations (3.1%). Cardiovascular and cutaneous manifestations were positively associated with age (p < 0.05). Goiter was associated with female sex (p = 0.005), cardiovascular (p = 0.02), neuropsychic (p = 0.03), skin (p = 0.03) signs and diarrhea (p = 0.03). Free T4 was correlated with age (p = 0.007), diarrhea (p = 0.021), anxiety (p = 0.024), heart rate (p = 0.00) and Graves' disease (p = 0.04). More voluminous the goiter, higher the free T4 (p = 0.007).
Conclusion: Hyperthyroidism in children differs from that in adults because of induction factors, growth disturbances and enuresis. Age and sex seem to favor the clinical picture of thyrotoxicosis and its associated signs.
PMID: 29138656 [PubMed - in process]
Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms.
Nat Sci Sleep. 2017;9:267-275
Authors: Skarpsno ES, Mork PJ, Nilsen TIL, Holtermann A
Background: In order to establish normative values for body positions and movements during sleep, the objective of this study was to explore the distribution of sleep positions and extent of nocturnal body moments and the association with sex, age, body-mass index (BMI), smoking, alcohol consumption, and insomnia symptoms.
Materials and methods: This cross-sectional study comprised data on a working population (363 men and 301 women) who participated in the Danish Physical Activity Cohort with Objective Measurements (DPHACTO). Measures of body position and movements were obtained from actigraph accelerometers on the thigh, upper back, and upper arm. Linear regression was used to estimate adjusted mean differences in movements among categories of demographic and lifestyle characteristics.
Results: During their time in bed, participants spent 54.1% (SD 18.1%) in the side position, 37.5% (SD 18.2%) in the back position, and 7.3% (SD 12.3%) in the front position. Increasing age and BMI were associated with increased time in the side position and a proportional reduction in time in the back position. There were on average 1.6 (SD 0.7) position shifts per hour. Compared to males, females had fewer position shifts (-0.37, 95% CI -0.48 to -0.24) and fewer arm, thigh, and upper-back movements. Participants aged 20-34 years had more arm, thigh, and upper-back movements compared to participants ≥35 years. Obese participants had fewer shifts in body position (-0.15, 95% CI -0.27 to 0), but more arm, thigh, and upper-back movements compared to normal-weight participants. Smokers had fewer shifts in body position than nonsmokers (-0.27, 95% CI -0.4 to -0.13).
Conclusion: The predominant sleep position in adults is on the side. This preference increases with age and BMI. The extent of nocturnal body movements is associated with sex, age, BMI, and smoking.
PMID: 29138608 [PubMed]
αvβ3 integrin-targeted micellar mertansine prodrug effectively inhibits triple-negative breast cancer in vivo.
Int J Nanomedicine. 2017;12:7913-7921
Authors: Zhong P, Gu X, Cheng R, Deng C, Meng F, Zhong Z
Antibody-mertansine (DM1) conjugates (AMCs) are among the very few active targeting therapeutics that are approved or clinically investigated for treating various cancers including metastatic breast cancer. However, none of the AMCs are effective for the treatment of triple-negative breast cancers (TNBCs). Here, we show that cRGD-decorated, redox-activatable micellar mertansine prodrug (cRGD-MMP) can effectively target and deliver DM1 to αvβ3 integrin overexpressing MDA-MB-231 TNBC xenografts in nude mice, resulting in potent tumor growth inhibition. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays showed that cRGD-MMP had obvious targetability to MDA-MB-231 cells with a low half-maximal inhibitory concentration (IC50) of 0.18 μM, which was close to that of free DM1 and 2.2-fold lower than that of micellar mertansine prodrug (MMP; nontargeting control). The confocal microscopy studies demonstrated that cRGD-MMP mediated a clearly more efficient cellular uptake and intracellular release of doxorubicin (used as a fluorescent anticancer drug model) in MDA-MB-231 cells. Notably, cRGD-MMP loaded with 1,1'-dioctadecyltetramethyl indotricarbocyanine iodide (DiR; a hydrophobic near-infrared dye) was shown to quickly accumulate in the MDA-MB-231 tumor with strong DiR fluorescence from 2 to 24 h post injection. MMP loaded with DiR could also accumulate in the tumor, although significantly less than cRGD-MMP. The biodistribution studies revealed a high DM1 accumulation of 8.1%ID/g in the tumor for cRGD-MMP at 12 h post injection. The therapeutic results demonstrated that cRGD-MMP effectively suppressed MDA-MB-231 tumor growth at 1.6 mg DM1 equiv./kg without causing noticeable side effects, as shown by little body weight loss and histological analysis. This MMP has appeared as a promising platform for potent treatment of TNBCs.
PMID: 29138558 [PubMed - in process]
Effects of weight loss interventions for adults who are obese on mortality, cardiovascular disease, and cancer: systematic review and meta-analysis.
BMJ. 2017 Nov 14;359:j4849
Authors: Ma C, Avenell A, Bolland M, Hudson J, Stewart F, Robertson C, Sharma P, Fraser C, MacLennan G
Objective To assess whether weight loss interventions for adults with obesity affect all cause, cardiovascular, and cancer mortality, cardiovascular disease, cancer, and body weight.Design Systematic review and meta-analysis of randomised controlled trials (RCTs) using random effects, estimating risk ratios, and mean differences. Heterogeneity investigated using Cochran's Q and I(2) statistics. Quality of evidence assessed by GRADE criteria.Data sources Medline, Embase, the Cochrane Central Register of Controlled Trials, and full texts in our trials' registry for data not evident in databases. Authors were contacted for unpublished data.Eligibility criteria for selecting studies RCTs of dietary interventions targeting weight loss, with or without exercise advice or programmes, for adults with obesity and follow-up ≥1 year.Results 54 RCTs with 30 206 participants were identified. All but one trial evaluated low fat, weight reducing diets. For the primary outcome, high quality evidence showed that weight loss interventions decrease all cause mortality (34 trials, 685 events; risk ratio 0.82, 95% confidence interval 0.71 to 0.95), with six fewer deaths per 1000 participants (95% confidence interval two to 10). For other primary outcomes moderate quality evidence showed an effect on cardiovascular mortality (eight trials, 134 events; risk ratio 0.93, 95% confidence interval 0.67 to 1.31), and very low quality evidence showed an effect on cancer mortality (eight trials, 34 events; risk ratio 0.58, 95% confidence interval 0.30 to 1.11). Twenty four trials (15 176 participants) reported high quality evidence on participants developing new cardiovascular events (1043 events; risk ratio 0.93, 95% confidence interval 0.83 to 1.04). Nineteen trials (6330 participants) provided very low quality evidence on participants developing new cancers (103 events; risk ratio 0.92, 95% confidence interval 0.63 to 1.36).Conclusions Weight reducing diets, usually low in fat and saturated fat, with or without exercise advice or programmes, may reduce premature all cause mortality in adults with obesity.Systematic review registration PROSPERO CRD42016033217.
PMID: 29138133 [PubMed - in process]
Low-dose vitamin D supplementation and incident frailty in older people: An eight year longitudinal study.
Exp Gerontol. 2017 Nov 11;101:1-6
Authors: Bolzetta F, Stubbs B, Noale M, Vaona A, Demurtas J, Celotto S, Cester A, Maggi S, Koyanagi A, Cereda E, Veronese N
Hypovitaminosis D is associated with frailty, but if vitamin D supplementation may prevent the onset of frailty is poorly known. Therefore, we aimed to investigate whether vitamin D supplementation is associated with a lower risk of frailty. In this longitudinal study, 4,421 individuals at high risk or having knee osteoarthritis free from frailty at baseline (mean age: 61.3, females=58.0%) were followed for 8 years. Details regarding vitamin D supplementation were captured by asking whether the participant took vitamin D during the previous year, at least once per month. Frailty was defined using the Study of Osteoporotic Fracture (SOF) index as the presence of at least two of the following criteria: (i) weight loss≥5% between baseline and any subsequent follow-up visit; (ii) inability to do five chair stands; (iii) low energy level according to the SOF definition. Multivariable Cox's regression analyses, calculating hazard ratios (HRs) with 95% confidence intervals (CIs), were undertaken. At baseline 69.7% took vitamin D supplements in the previous year, with a mean dose of 384±157 IU per day. During the 8-year follow-up, no difference in the incidence of frailty was evident by vitamin D supplementation status at baseline, even after adjusting for 13 baseline confounders (HR=0.95; 95% CI: 0.72-1.25). Similar results were obtained using the propensity score (HR=0.95; 95% CI: 0.71-1.25) or age- and sex-matched controls (HR=1.00; 95% CI: 0.75-1.33). In conclusion, low-dose vitamin D supplementation was not associated with any decreased risk of frailty during eight years of follow-up in a large cohort of North American people. Future large-scale trials with high doses of oral vitamin D and longer follow-up are needed to confirm/refute our findings.
PMID: 29137947 [PubMed - as supplied by publisher]
Effect of ultrasound treatments on functional properties and structure of millet protein concentrate.
Ultrason Sonochem. 2018 Mar;41:382-388
Authors: Nazari B, Mohammadifar MA, Shojaee-Aliabadi S, Feizollahi E, Mirmoghtadaie L
In this study, the effect of high power ultrasound (US) probe in varying intensities and times (18.4, 29.58, and 73.95 W/cm(2) for 5, 12.5 and 20 min respectively) on functional properties of millet protein concentrate (MPC) was investigated, and also the structural properties of best modified treatment were evaluated by FTIR, DSC, Zeta potential and SDS-PAGE techniques. The results showed the solubility in all US treated MPC was significantly (p < .05) higher than those of the native MPC. Foaming capacity of native MPC (271.03 ± 4.51 ml) was reduced after US treatments at low intensities (82.37 ± 5.51 ml), but increased upon US treatments at high intensities (749.7 ± 2 ml). In addition, EAI and ES increased after US treatments. One of the best US treatments that can improve the functional properties of MPC was 73.95 W/cm(2) for 12.5 min that resulted in reduction of molecular weight and increase nearly 36% in the negative surface charge that was confirmed by SDS-page and Zeta potential results, respectively.
PMID: 29137765 [PubMed - in process]
Effects of increased myocardial tissue concentration of myristic, palmitic and palmitoleic acids on the course of cardiac atrophy of the failing heart unloaded by heterotopic transplantation.
Physiol Res. 2017 Nov 10;
Authors: Pokorný M, Mrázová I, Malý J, Pirk J, Netuka I, Vaňourková Z, DoleŽelová Š, Červenková L, Maxová H, Melenovský V, Šochman J, Sadowski J, Červenka L
The present experiments were performed to evaluate if increased heart tissue concentration of fatty acids, specifically myristic, palmitic and palmitoleic acids that are believed to promote physiological heart growth, can attenuate the progression of unloading-induced cardiac atrophy in rats with healthy and failing hearts. Heterotopic abdominal heart transplantation (HT(x)) was used as a model for heart unloading. Cardiac atrophy was assessed from the ratio of the native- to-transplanted heart weight (HW). The degree of cardiac atrophy after HT(x) was determined on days 7, 14, 21 and 28 after HT(x) in recipients of either healthy or failing hearts. HT(x) of healthy hearts resulted in 23+/-3, 46+/-3, 48+/-4 and 46+/-4 % HW loss at the four time-points. HT(x) of the failing heart resulted in even greater HW losses, of 46+/-4, 58+/-3, 66+/-2 and 68+/-4 %, respectively (P<0.05). Activation of "fetal gene cardiac program" (e.g. beta myosin heavy chain gene expression) and "genes reflecting cardiac remodeling" (e.g. atrial natriuretic peptide gene expression) after HT(x) was greater in failing than in healthy hearts (P<0.05 each time). Exposure to isocaloric high sugar diet caused significant increases in fatty acid concentrations in healthy and in failing hearts. However, these increases were not associated with any change in the course of cardiac atrophy, similarly in healthy and post-HT(x) failing hearts. We conclude that increasing heart tissue concentrations of the fatty acids allegedly involved in heart growth does not attenuate the unloading-induced cardiac atrophy.
PMID: 29137478 [PubMed - as supplied by publisher]
An evaluation of nutrition intervention during radiation therapy in patients with locoregionally advanced nasopharyngeal carcinoma.
Oncotarget. 2017 Oct 13;8(48):83723-83733
Authors: Jin T, Li KX, Li PJ, Huang S, Chen XZ, Chen M, Hu QY, Shi L, Chen YY
Purpose: To evaluate the effectiveness of nutrition intervention during radiation for patients with locoregionally advanced (III-IVa) nasopharyngeal carcinoma (NPC).
Materials and Methods: We retrospectively reviewed 117 patients with locoregionally advanced (III-IVa) NPC treated between December 2015 and March 2016 in Zhejiang Cancer Hospital. All the patients underwent radical chemo-radiotherapy. First, all the patients were divided into the nutrition intervention group and the control group, depending on whether they accepted nutrition intervention. Repeated measures were used to analyze the change of nutritional indicators before, during, and after radiation therapy and to simultaneously compare the difference in nutritional status between the two groups at the same time point. Subsequently, the 117 patients were divided into the malnourished group (weight loss > 5%) and the non-malnourished group (weight loss ≤ 5%) according to whether their weight loss was over 5% of their body weight during radiotherapy. Chi-square tests and logistic regression analysis were used to explore the influence factors for the weight loss.
Results: The repeated measures showed that all indicators including weight, body mass index (BMI), albumin, pre-albumin(PA), and prognostic nutritional index (PNI) dramatically declined in both groups compared with their levels before radiation therapy (All p < 0.001). However, there was no significant difference between the intervention and non-intervention groups regarding the mean values of nutritional indicators at the same time point, that before, during, and after radiation therapy, except BMI (All p > 0.05). Logistic regression analysis revealed grade ≥ 3 radiation-induced oral mucositis as the prognostic factor for a poor nutrition status (odds ratio, OR = 3.232, p = 0.021, confidence interval, CI [1.198, 8.820]). Besides this, patients with a decrease of >15% in pre-albumin level were more likely to be malnourished (OR = 2.442, p = 0.041, CI [1.036, 5.757]). Similar to that observed in our former analysis, we did not find that existing nutrition intervention can significantly improve nutritional status (OR = 1.217, p = 0.704, CI [0.042, 3.348]).
Conclusions: Our study shows that the nutritional status of the patients gradually declined during treatment. We concluded that grade ≥ 3 radiation-induced oral mucositis would aggravate the extent of malnutrition during radiation therapy in patients with locoregionally advanced NPC. Pre-albumin level was a predictive marker for weight loss in patients with NPC. However, current nutrition intervention during radiation therapy can't significantly reverse nutritional status.
PMID: 29137377 [PubMed]
Effects of growth hormone on cardiac remodeling and soleus muscle in rats with aortic stenosis-induced heart failure.
Oncotarget. 2017 Oct 10;8(47):83009-83021
Authors: Lima ARR, Pagan LU, Damatto RL, Cezar MDM, Bonomo C, Gomes MJ, Martinez PF, Guizoni DM, Campos DHS, Damatto FC, Okoshi K, Okoshi MP
Background: Skeletal muscle wasting is often observed in heart failure (HF). The growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis is impaired in HF. In this study, we evaluated the effects of GH on soleus muscle and cardiac remodeling in rats with aortic stenosis (AS)-induced HF.
Methods: AS was created by placing a stainless-steel clip on the ascending aorta. After clinically detecting HF, GH (2 mg/kg/day) was subcutaneously injected for 14 days (AS-GH group). Results were compared with those from Sham and non-treated AS groups. Transthoracic echocardiogram was performed before and after treatment. Protein expression was evaluated by Western blot and satellite cells activation by immunofluorescence. Statistical analyzes: ANOVA and Tukey or Kruskal-Wallis and Student-Newman-Keuls.
Results: Before treatment both AS groups presented a similar degree of cardiac injury. GH prevented body weight loss and attenuated systolic dysfunction. Soleus cross-sectional fiber areas were lower in both AS groups than Sham (Sham 3,556±447; AS 2,882±422; AS-GH 2,868±591 μm(2); p=0.016). GH increased IGF-1 serum concentration (Sham 938±83; AS 866±116; AS-GH 1167±166 ng/mL; p<0.0001) and IGF-1 muscle protein expression and activated PI3K protein. Neural cell adhesion molecule (NCAM) immunofluorescence was increased in both AS groups. Catabolism-related intracellular pathways did not differ between groups.
Conclusion: Short-term growth hormone attenuates left ventricular systolic dysfunction in rats with aortic stenosis-induced HF. Despite preserving body weight, increasing serum and muscular IGF-1 levels, and stimulating PI3K muscle expression, GH does not modulate soleus muscle trophism, satellite cells activation or intracellular pathways associated with muscle catabolism.
PMID: 29137319 [PubMed]
Clinical outcome of dynamic hip locking plates and proximal femoral nails anti-rotation-Asia for treating intertrochanteric femur fracture with lateral wall fractures in the elder patients.
Oncotarget. 2017 Oct 10;8(47):82700-82704
Authors: Xie H, Wang Z, Zhang J, Xu L, Chen B
Purpose: To compare the clinical results of DHLP (Dynamic hip locking plates) and PFNA-IIs (proximal femoral nails anti-rotation-Asia) for treating intertrochanteric femur fracture (IFF) with lateral wall fractures in the elder patients and provide a rationale for the clinical practice.
Methods: A retrospective analysis of 43 patients of IFF with lateral wall fractures was performed from December 2009 to April 2015. Intraoperative variables and postoperative complications and function were compared between the two groups.
Results: 17 cases were treated by DHLPs, and 26 treated by PFNA-IIs. Patients were followed up from 6 to 16 months with an average of 11 months. Both the groups were comparable for demographic data before surgery. The PFNA-II group had less operation time, time of full weight bearing and healing time of fracture, but larger blood loss in comparison with the DHLP group (p<0.05). Additionally, internal fixation failure was significantly more in the DHLP group than in the PFNA-II group. The mean HHS and the rate of good-to-excellent in the PFNA-II group was significantly higher than that in the DHLP group both in third month after surgery (p<0.05).
Conclusions: PFNA-IIs treatment should be recommended for the elderly patients of IFF with lateral wall fractures, because of its shorter operation time, faster full weight bearing, faster function recovery, and lower failure rate. However, more attention should be payed to its larger blood loss.
PMID: 29137295 [PubMed]
Pancreatic Exocrine Insufficiency after Bariatric Surgery.
Nutrients. 2017 Nov 13;9(11):
Authors: Vujasinovic M, Valente R, Thorell A, Rutkowski W, Haas SL, Arnelo U, Martin L, Löhr JM
Morbid obesity is a lifelong disease, and all patients require complementary follow-up including nutritional surveillance by a multidisciplinary team after bariatric procedures. Pancreatic exocrine insufficiency (PEI) refers to an insufficient secretion of pancreatic enzymes and/or sodium bicarbonate. PEI is a known multifactorial complication after upper gastrointestinal surgery, and might constitute an important clinical problem due to the large number of bariatric surgical procedures in the world. Symptoms of PEI often overlap with sequelae of gastric bypass, making the diagnosis difficult. Steatorrhea, weight loss, maldigestion and malabsorption are pathognomonic for both clinical conditions. Altered anatomy after bypass surgery can make the diagnostic process even more difficult. Fecal elastase-1 (FE1) is a useful diagnostic test. PEI should be considered in all patients after bariatric surgery with prolonged gastrointestinal complaints that are suggestive of maldigestion and/or malabsorption. Appropriate pancreatic enzyme replacement therapy should be part of the treatment algorithm in patients with confirmed PEI or symptoms suggestive of this complication.
PMID: 29137169 [PubMed - in process]
A case report of Schatzker type VI tibial plateau fracture treated with double reverse traction closed reduction combined with minimally invasive percutaneous plate osteosynthesis technique: A case report.
Medicine (Baltimore). 2017 Nov;96(45):e8394
Authors: Li DQ, Song DY, Ni JD, Ding ML, Huang J
RATIONALE: The knee joint is an important weight-bearing joint, tibial plateau fractures affect knee function and stability. High-energy intra-articular fractures involving the tibial plateau can cause management-related problems such as wound dehiscence; severe comminution leading to malalignment; and delayed complications such as varus collapse, implant failure, and arthritis of the knee joint. The treatment of severe or complex tibial plateau fractures can be quite difficult. Traditional methods of open reduction and plating require extensive exposures, which may further compromise soft tissue and devascularize bone fragments, leading to infection. In this case, a novel device, double reverse traction combined with MIPPO technique, was used and provided the possibility of minimally invasive and personalized orthopedic surgery to treat severe comminuted Schatzker type VI tibial plateau fracture and tibial shaft fracture and got satisfactory results.
PATIENT CONCERNS: A previously healthy 56-year-old man presented to the emergency room after a fall from a height, who lost the movement of the left knee with pain and swelling.
DIAGNOSES: X-rays showed a tibial plateau comminuted fracture, Schatzker type VI, and tibial shaft fracture.
INTERVENTIONS: Applying less extensile exposure and the indirect reduction technique of double reverse traction and closed reduction combined with minimally invasive percutaneous plate osteosynthesis (MIPPO) technique, we got satisfactory recovery of the severe comminuted Schatzker type VI tibial plateau fracture and tibial shaft fracture.
OUTCOMES: This severe comminuted fracture and tibial shaft fracture were successfully reduced and got satisfactory recovery of knee joint function.
LESSONS: Double reverse traction combined with MIPPO technique can reduce the risk of surgical complications, such as bleeding, oozing, and wound infection. It can be applied in patients with comorbidities such as cardiac disease, hypertension, and heart failure who may otherwise not be candidates for surgery. The cost burden is lower than that of the traditional traction table.
PMID: 29137023 [PubMed - in process]