Hand grip strength: A reliable assessment tool of frailty status on the person with type 2 diabetes mellitus

ObjectiveThe aim was to assess the influence of specific type 2 diabetes Mellitus-related features on the hand grip strength in a diabetic outpatient-based population.Material and methodsA cross-sectional population-based study was conducted. Seventy-three individuals were included after excluding cases of refusal to participate or medical concerns that had potential to affect dominant hand strength. A calibrated dynamometer was used to assess dominant hand grip strength. Two multiple linear regression models were used to predict mean hand grip strength values. Spearman and Pearson correlations were calculated for all possible pairwise combinations of significant independent continuous variables and mean hand grip strength values.ResultsReduced hand grip strength prevalence was 54.8%, from which 70.8% people had ≥ 65 years. Twenty four percent of individuals aged < 65 years showed decreased hand grip strength. Increasing age, female gender and type 2 diabetes Mellitus duration were significantly associated with reduced hand grip strength (P < 0.001; P = 0.017; P = 0.001, respectively). For each 10 years of disease duration, individual mean hand grip strength decreased around 3 kg (P = 0.001).ConclusionsReduced hand grip strength prevalence was substantial in the geriatric subgroup and not negligible in younger patients with a contribution long-term Diabetes, increasing age and female gender as risk factors. This study displays a unique, practical and reliable approach to select at-risk patients who need close screening programs and clinical surveillance concerning frailty status.     

Dietary selenium intake and risk of type 2 diabetes in a female population of western Algeria

Several studies have raised possible associations between high selenium exposure and type 2 diabetes. Here we investigate the association between dietary selenium intake and the risk of type 2 diabetes in a female population from western Algeria. The analytical study included a total sample of 290 women, 140 type 2 diabetics and 150 controls. The dietary selenium intake has been measured by a 72-hour dietary recall. The odds ratio (OR) and the corresponding 95% confidence interval (CI) were used to determine the relationship between dietary selenium intake and diabetes through logistic regression. The quartile in the range of recommended dietary selenium intake was considered as a reference. The average level of dietary selenium intake was 72.40 μg/day in diabetics and 70.30 μg/day in controls (P > 0.05). The odds ratio for diabetes, comparing the highest quartile of dietary selenium intake to the reference quartile was 2.21 (95% CI 1.06–4.38; P = 0.036). While the lowest quartile had an odds ratio of 2.52 (95% CI 1.25–5.09; P = 0.010). In conclusion, this study indicates that there is a significant association between the risk of type 2 diabetes and both high and low dietary selenium intake.     

Séroprévalence du VIH et facteurs associés chez les hommes ayant des rapports sexuels avec d’autres hommes au Togo

BackgroundLimited data are available on HIV infection among vulnerable populations in sub-saharan African countries, especially among men who have sex with men (MSM). The aim of this study was to estimate HIV prevalence and the factors associated with HIV infection among MSM in Togo in 2011.MethodA cross-sectional survey was carried out among MSM aged at least 18 years old, living in Togo for at least 3 months. They were recruited through the snowball method in six cities of Togo from November 2011 to January 2012. A survey form was used and an HIV screening test was proposed to the participants. The HIV prevalence was estimated with a 95% confidence interval. Univariate and multivariate analyses were performed to identify factors associated with HIV infection.ResultsA total of 758 MSM were enrolled in this study, including 498 (67.5%) from Lomé, the capital of Togo. The median age was 24 years with an interquartile range of [21–27 years] and 271 MSM (35.7%) were students. The vast majority of MSM were Togolese (90.3%) and 14.6% were married or committed to a woman. HIV testing was accepted by 488 MSM (64.3%) but only 408 (53.8%) finally accepted a blood sample collection. The prevalence of HIV infection was 19.6% [95% confidence interval, 15.9–23.8]. In multivariate analysis, three factors were associated with HIV infection: living in Lomé, with an HIV prevalence of 29.8% against 4.3% in the other cities of Togo [adjusted odds ratio (aOR) = 9.68; P < 0.001]; having a good knowledge of HIV transmission modes (aOR = 0.59; P = 0.049); and not having a regular sex partner (aOR = 1.69; P = 0.049).ConclusionOne MSM out of five was HIV-infected. Intervention programs targeting this vulnerable population are urgently needed, to reduce HIV incidence in Togo.     

Overweight and obesity in Eastern Morocco: Prevalence and associated risk factors among high school students

BackgroundOverweight and obesity in children and adolescents have become a major public health problem affecting most countries worldwide. The purpose of the study was to assess the prevalence and risk factors of overweight and obesity among public high school students in Eastern Morocco.MethodsA cross-sectional survey was conducted between February and May 2014 among a sample of 2271 students (1086 girls and 1185 boys). References from the International Obesity Task Force (IOTF) were used to determine the prevalence of overweight and obesity.ResultsThe prevalence of overweight and obesity reached 12.2% (14.2% in girls vs 10.4% in boys, P < 0.01) and 3.0% (3.1% in girls vs 2.8% in boys), respectively. Risk factors associated with overweight and obesity were urban residence (OR = 1.76; [1.18–2.63]; P < 0.01), father's income ≥ 5000 MAD (OR = 1.32; [1.02–1.70]; P < 0.05), father's overweight (including obesity) (OR = 1.87; [1.38–2.54]; P < 0.001) and female sex (OR = 1.31; [1.02–1.68]; P < 0.05).ConclusionThe prevalence of overweight/obesity has reached an alarming rate among high school students in the Eastern region of Morocco. The findings of the present study suggest an urgent need to set up a strategy to prevent and combat this epidemic.     

Determining the risk of diabulimia and its relationship with diet quality and nutritional status of adolescents with type 1 diabetes

IntroductionDiabulimia is known as an eating disorder specific to individuals with diabetes.ObjectivesIn this study, it was aimed to determine the diabulimia risk and to evaluate the possible relationships between diabulimia risk and diet quality, anthropometric measurements, and biochemical parameters of adolescents with type 1 diabetes.Material and methodsIn total, 110 adolescents (male: 51.8%, female: 48.2%) with type 1 diabetes between 10–19 years were included in the study. Sociodemographic characteristics and information about diabetes of adolescents were collected using a questionnaire prepared by the researchers through face-to-face interview technique. Anthropometric measurements and 3-day food consumption records were obtained to evaluate their nutritional status, and their biochemical parameters were obtained from hospital files to evaluate their metabolic status. The diet quality was evaluated using the Healthy Eating Index-2015. Diabetes Eating Problem Survey was administered to individuals and it was accepted that diabetics with a total score of ≥ 20 were at risk of diabetes-related eating disorders.Results/ConclusionAmong the 110 adolescents included in this study, 31.8% were found to be at risk of diabulimia. There was a significant relationship between the groups with and without diabulimia risk in terms of diet quality scores (P < 0.05). All individuals with a risk of diabulimia as well as 86.8% of individuals without a risk of diabulimia had high HbA1c levels (P < 0.05). Diet quality, some anthropometric measurements and biochemical parameters of adolescents at risk of diabulimia should be improved. It is important to periodically evaluate the risk of diabulimia, the diet quality, and the nutritional status of adolescents with type 1 diabetes to reduce the occurrence of short and long-term complications.     

Profils métabolique et clinique avant,pendant et après la période du ramadan chez des Maliens atteints de diabète de type 2

ObjectivesTo document the effects of fasting on metabolic and clinical parameters among Malians with type 2 diabetes during Ramadan in Mali.MethodsThis study was conducted with 25 subjects attending the Centre national de lutte contre le diabète in Bamako. Only those that intended to observe the Ramadan fasting in 2010 were selected. Biological and clinical parameters were measured in 25 participants at three different periods: before Ramadan (T0), during the fourth week of Ramadan (T1) and one month after Ramadan (T2).ResultsCompared to T0, an increase was noted at T1 in fasting blood glucose (P < 0.05) and systolic blood pressure (P < 0.01), although not maintained at T2. Glycosylated haemoglobin was also higher at T2 compared to T0 (P < 0.02). Degradation of glycemic control was more marked among patients who had stopped or reduced their doses of medication at T1 (P < 0.01). Also, a decrease in LDL-cholesterol (P < 0.03), total cholesterol (P < 0.05) and total cholesterol/HDL-cholesterol ratio (P < 0.01) were observed at T1, along with a slight weight loss (P < 0.01). Reductions in weight, levels of LDL-cholesterol and total cholesterol/HDL-cholesterol ratio were maintained at T2.ConclusionsThis study showed an adverse effect of fasting on glycemic control among the participants, likely related to the non-observance of oral medication during Ramadan. However, blood lipids sharply improved during Ramadan, and even after.     

Progression of quality of life in patients with grade 3 obesity after a 36 months care pathway with and without bariatric surgery

ObjectivesBeyond somatic consequences, excess weight affects quality of life. In the literature this has markedly improved in the first 6 months, but has decreased later. The originality of our work in that is based on the comparison of two groups of patients, surgical and non-surgical ones, monitored by a multi-professional team for 3 years.MethodsThe sample is comprised of 32 subjects divided into two groups: 17 subjects from the non-surgical pathway and 15 from the surgical one. The Quality of Life, Obesity, and Dietetics questionnaire (QOLOD), the Hospital Anxiety and Depression Scale (HADS) and the Dutch Eating Behaviour Questionnaire (DEBQ), age, BMI, and sex were recorded.ResultsAt baseline, age was significantly different between two groups (surgery vs. non-surgery). BMI and QOLOD improvement were significantly more important in surgical group (?13.6 kg [?19.2; ?10.8] vs. 0.0 kg [?2.8; 3.0] P < 0.001 and 16.9 [8.5; 32.2 vs. 2.1 [?9.4; 16.2], P = 0.004). The progression of the QOLOD score correlated negatively with the progression of BMI (r = ?0.5, P = 0.005)ConclusionThere is a link between post-surgery weight loss and improved quality of life at 36 months. We suggest a qualitative follow-up survey for surgical and non-surgical obese patients.     

Profil épidémiologique des femmes victimes de violences psychologiques en période pré- et post-partum dans la région de Sédhiou,Sénégal

BackgroundIn Senegal, psychological violence remains a taboo subject insofar as it often arises in the closed circle of family life. It has a highly negative impact on the health of pregnant women. The objective of this work was to study the epidemiological profile of female victims of psychological violence before and after birth in the Sédhiou region.MethodAn observational, cross-sectional and analytical study was carried out from December 4, 2018 to April 4, 2019. The study population consisted of all the women received for postnatal consultation in one of the referral health structures in the Sédhiou region. Data were collected using a survey form and a questionnaire administered to the women having met the inclusion criteria. The data were entered using CS Pro software and subsequently analyzed using R 3.4.4 software.ResultsThe mean age of the women was 25.4 ± 7.8 (14–43 years). A total of 222 women (55.5 %) had suffered psychological violence during the prepartum period. Isolated psychological violence represented 44.3 % of the surveyed population, while psychological violence associated with sexual or physical violence represented 8.0 % and 5.4 % of the respondent population, respectively. The factors associated with psychological violence during the prepartum period were pursuit of a professional activity [ORaj = 4.7 (1.3–17.0)], high educational status [ORaj = 7.0 (4.2–11.5)] and performance of fewer than 3 antenatal consultations (ANC) [ORaj = 2.2 (1.2–4.0)]. Maternal, fetal and neonatal complications were more frequent among victims of psychological violence (P < 0.05). During the postpartum period, 26.5 % of the women who had been victims of violence during the prepartum period mentioned the fact that the aggression had ceased. The other women continued to endure violence, which was even more intense among 2.5 %.ConclusionPsychological violence among pregnant women has a negative impact on the health of the mother and the newborn. This state of affairs should induce health care providers to increase popular awareness of its detrimental effects. Communication efforts aimed at behavioral change will need to be combined during prenatal consultations with strengthened screening for violence, the objective being to achieve improved care.     

Assessment of energy expenditure,physical activity and sleep pattern in patients with frequent symptomatic ventricular ectopic beats

BackgroundVentricular ectopic beats (VEBs) are considered as benign ventricular arrhythmias in patients without structural heart disease. However, symptomatic frequent VEBs can adversely affect energy metabolism. The present study aimed to determine the effect of symptomatic frequent VEBs on energy expenditure, physical activity and sleep pattern.MethodsThirty-seven patients with symptomatic frequent VEBs and no structural heart diseases were enrolled. Patients underwent simultaneous 24-hour-ambulatory Holter electrocardiogram monitoring and the BodyMedia armband device monitoring which measures energy expenditure. Data acquired from both devices were compared with the data acquired from healthy volunteers in the control group.ResultsTotal energy expenditure (TEE) was higher in the patient group than the control group (1470 ± 353 kcal vs 1125 ± 275 kcal, P < 0.001). Average metabolic equivalence (aMETs) (1.1 ± 0.2 vs. 1.3 ± 0.2, P = 0.028), physical activity duration (PAD) (0.35 vs. 0.48, P = 0.007) and sleep duration (SDN) (3.15 vs. 4.31, P = 0.004) were significantly lower in the patient group than control group. VEBs frequency was inversely correlated with only SDN (r = −0.374, P = 0.027).ConclusionTotal energy expenditure (TEE) is increased in patients with symptomatic frequent VEBs in comparison with healthy subjects while PAD, average metabolic equivalence (aMETs) and SDN are decreased. VEBs frequency was inversely correlated with SDN.     

Acute kidney injury in infective endocarditis: A retrospective analysis

BackgroundAcute kidney injury (AKI) is associated with high case fatality in infective endocarditis (IE), but epidemiological data on the frequency of AKI during IE is scarce. We aimed to describe the frequency and risk factors for AKI during the course of IE using Kidney Disease: Improving Global Outcomes consensual criteria.MethodsUsing the French hospital discharge database (French acronym PMSI), we retrospectively reviewed the charts of 112 patients presenting with a first episode of probable or definite IE between January 2010 and May 2015.ResultsSeventy-seven patients (68.8%) developed AKI. In univariate analysis, risk factors for AKI were cardiac surgery for IE (n = 29, 37.7% vs. n = 4, 1.4%, P < 0.0005), cardiac failure (n = 29, 36.7% vs. n = 1, 2.9%, P < 0.0005), diabetes mellitus (n = 14, 18.2% vs. n = 1, 0.9%, P = 0.034), and prosthetic valve IEs (n = 24, 31.2% vs. n = 4, 11.4%). No differences were observed for gentamicin exposure (n = 57, 64% vs. n = 32, 86.5%, P = 0.286). Prosthetic valve IE, cardiac failure, and vancomycin exposure were independently associated with AKI with respective odds ratio of 5.49 (95% CI 1.92–17.9), 4.37 (95% CI 4.37–465.7), and 1.084 (1.084–16.2). Mean length of hospital stay was significantly longer in patients presenting with AKI than in controls (respectively 52.4 ± 22.1 days vs. 39.6 ± 12.6, P < 0.005).ConclusionAKI is very frequent during IE, particularly in patients with prosthetic valve IE, cardiac failure, and those receiving vancomycin.     

Relationship between malnutrition and sarcopenia in elderly Turkish community-dwellers

ObjectivesSarcopenia is frequently seen at older ages, with primary sarcopenia being associated with mitochondrial dysfunction or age-related decreases in sex hormones while other explanations include endocrine and neurodegenerative diseases. This study was planned and conducted to determine the relationship between malnutrition and sarcopenia in elderly Turkish community-dwellers.Material and methodsIn total, 173 community-dwelling elderly individuals were recruited from the capital city of Turkey. A questionnaire form was applied via face-to-face method and the MNA-SF and Barthel Index were administered. In addition, some anthropometric measurements were taken.ResultsBody mass (P < 0.05) and body height (P < 0.05) were higher in non-sarcopenic elderly individuals. Age was lower in non-sarcopenic elderly (P < 0.05). In this study, while the prevalence of sarcopenia was 50.2% in the elderly, the prevalence of malnutrition risk was found to be 42.2%. MNA-score was found to be significantly lower in sarcopenic elderly individuals. There was a strong relationship between sarcopenia and malnutrition risk, but not with daily living activities.ConclusionThe prevalence of sarcopenia was much higher than prevalence of risk at malnutrition. In Turkey, there is no bioelectrical impedance analysis performed among such community-dwellers, so this is the first study not using BIA while screening for sarcopenia in elderly community-dwellers. This study suggests that current nutritional policies in Turkey should target elderly individuals living in communities to screen for nutritional status regularly and apply interventions quickly. In doing so, there is no need for expensive equipment.     

The MTHFR C677T mutation is not a risk factor recognized for HBV-related HCC in a population with a high prevalence of this genetic marker

BackgroundPolymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene can affect disease progression in HBV infection. However, the results from different reports are inconsistent. The aim of this study was to investigate the association between the MTHFR C677T polymorphism and the outcome of HBV infection in a Tianjin Han population.MethodsTaqMan SNP genotyping was employed to determine the alleles and genotypes of MTHFR C677T in 2511 subjects from various stages of HBV infection and 549 healthy controls.ResultsOf the 3060 subjects, the genotypic frequencies were CT 48.9%, TT 29.3% and CC 21.8%; the allelic frequencies were T 53.8% and C 46.2%. There was no significant difference in genotypic or allelic distribution among the different disease groups. When either healthy subjects or self-limited subjects were used as controls, the TT genotype and the T allele conferred protective effects against hepatocellular carcinoma (HCC) (HCC vs healthy subjects: OR = 0.588, 95% CI = 0.413–0.836, P = 0.003; OR = 0.768, 95% CI = 0.645–0.915, P = 0.003, respectively. HCC vs self-limited subjects: OR = 0.598, 95% CI = 0.404–0.886, P = 0.010; OR = 0.772, 95% CI = 0.635–0.940, P = 0.010, respectively). After sub-stratification by gender, the prevalence of the TT genotype or T allele was the lowest in the male HCC group (TT 23.5%, T 49.8%). The protective effects of the TT genotype and the T allele were observed in male HCC and cirrhotic subjects (HCC vs self-limited subjects: OR = 0.470, 95% CI = 0.288–0.766, P = 0.002; OR = 0.681, 95% CI = 0.535–0.866, P = 0.002, respectively. Liver cirrhosis vs self-limited subjects: OR = 0.624, 95% CI = 0.392–0.992, P = 0.046; OR = 0.791, 95% CI = 0.627–0.998, P = 0.048, respectively), but not in female. When the subjects were stratified according to the clinical features, no statistically significant difference in the genotypic distribution was observed (P > 0.05).ConclusionsThe TT genotype and T allele of MTHFR C677T may confer a protective effect on disease progression to HCC in HBV-infected individuals, especially among male patients, in a population with a high prevalence of this genetic marker.     

Inadequate diabetes knowledge is associated with poor glycemia control in patients with type 2 diabetes

ObjectiveTo identify the association between glycemia control with level of diabetes knowledge, diabetes education, and lifestyle variables in patients with type 2 diabetes.DesignCross-sectional analytical study.SiteClinics of the Mexican Institute of Social Security (IMSS), Mexico.ParticipantsPatients with type 2 diabetes.Main measurementsGlycated hemoglobin (HbA1c), glucose, and lipid profile levels were measured from fasting venous blood samples. Assessment of disease knowledge was performed using the Diabetes Knowledge Questionnaire (DKQ-24). Systolic and diastolic blood pressure was measured. Weight and abdominal circumference were measured, as well as body composition using bioimpedance. Sociodemographic, clinical, and lifestyle variables were obtained.ResultsA total of 297 patients were included, sixty-seven percent (67%) were women with a median of six years since the diagnosis of diabetes. Only 7% of patients had adequate diabetes knowledge, and 56% had regular knowledge. Patients with adequate diabetes knowledge had a lower body mass index (p = 0.016), lower percentage of fat (p = 0.008), and lower fat mass (p = 0.018); followed a diet (p = 0.004) and had received diabetes education (p = 0.002), and to obtain information about their illness (p = 0.001). Patients with low levels of diabetes knowledge had a higher risk of HbA1c ≥ 7% (OR: 4.68; 95% CI: 1.48,14.86; p = 0.009), as well as those who did not receive diabetes education (OR: 2.17; 95% CI: 1.21–3.90; p = 0.009) and those who did not follow a diet (OR: 2.37; 95% CI: 1.01,5.55; p = 0.046).ConclusionInadequate knowledge of diabetes, lack of diabetes education, and dietary adherence are associated with poor glycemia control in patients with diabetes.     

Prévalence de l’obésité et du surpoids chez les écoliers de primaire à Marrakech,Maroc

BackgroundChildhood obesity is a phenomenon of growing concern today because of its rapid growth worldwide. The aim of our study was to estimate the prevalence of overweight and obesity among school age children in Marrakech.MethodsWe conducted a cross-sectional study of a random sample of 1418 schoolchildren aged 8–15 years in the public sector in Marrakech in May 2011. Trained physicians measured the weight and size of respondents. The body mass index (BMI) was calculated for each child. Overweight was assessed by comparing BMI with World Health Organization (WHO) and International Obesity Task Force (IOTF) references. Statistical analysis was performed using SPSS version 16.0 and using a macro of WHO Anthro for SPSS.ResultsThe mean age was 10.8 ± 1.6 years. The sex ratio (girl/boy) was 1. The prevalence of overweight and obesity were 8 % (95 % CI [6.7, 9.6]) and 3 % (95 % CI [2.2, 4.1] based on WHO reference. This prevalence were respectively 12.2 % (95 % IC [10.5; 14.0]) and 5.4 % (95 % IC [4.3; 6.7]) using the IOTF reference.ConclusionIn the absence of national data, our results reflect the importance of the phenomenon in our context, hence the importance of monitoring the nutritional status on both individual and collective levels and the need to develop strategies for prevention, diagnosis and early treatment before the problem becomes more widespread.     

Contribution of maternal diabetes to visceral fat accumulation in offspring

Background/objectivesGenetic and epidemiological studies provide evidence supporting the contribution of a genetic background of diabetes to the development of obesity and further suggest differences in the metabolic and cardiovascular risks between offspring with a paternal versus maternal family history of diabetes (FHD). The goal of this study was to explore the contribution of a parental FHD to visceral fat area (VFA).Subjects/methodsThis study enrolled 1875 subjects with normal glucose tolerance (age range: 20–78 years). VFA was assessed with magnetic resonance imaging.ResultsThe study population consisted of 1573 subjects without a FHD, 115 subjects with a paternal FHD, and 187 subjects with a maternal FHD. For both genders, VFA was greater in offspring with a maternal FHD compared with those without a FHD (both P < 0.05). For both genders, only VFA was an independent factor associated with a maternal FHD (both P < 0.01). Compared with those without a FHD, men and women with a maternal FHD, but not those with a paternal FHD, were more likely to develop abdominal obesity (both P < 0.05). After adjustment for independent factors related to VFA, VFA was increased by 9.60 cm² (standardized β = 0.069, P = 0.012) and 4.57 cm² (standardized β = 0.056, P = 0.007) in men and women with a maternal FHD, respectively.ConclusionA maternal FHD contributed to visceral fat accumulation independently in both genders. Maternal transmission had a pronounced effect on obesity and related cardiovascular risk factors.     

High rates of antiretroviral coverage and virological suppression in HIV-1-infected children and adolescents

ObjectivesTo assess the outcome of HIV-infected individuals attending one of the largest French pediatric HIV centers in 2016–2017 and to compare the rates of antiretroviral coverage and virological suppression with the UNAIDS targets.Patients and methodsThe clinical and immuno-virological status of 163 HIV-1-infected children and adolescents attending Necker Hospital in Paris, France, were investigated. Virological suppression was defined as an HIV-1 viral load < 50 copies/mL for at least six months. All genotypic resistance tests performed since birth were analyzed.ResultsMost patients were born in Sub-Saharan African countries (41.7%) or in France (38.0%). Their median age was 14 years [IQR 7.3–17.0]. Although 33.7% of individuals had a history of AIDS-defining clinical event(s), 86.5% of children/adolescents were free from HIV-related symptoms at their most recent evaluation. Antiretroviral coverage was high (98.2%; mainly including one integrase inhibitor [42.3%] or one protease inhibitor [23.9%]). At the last visit, most patients (82.8%) had normal CD4 T lymphocytes counts (≥ 25%). Although 61.7% of antiretroviral-experienced children had resistance to ≥ 1 drug class and 9.2% had triple-class resistance, 80.3% of patients receiving antiretrovirals for ≥ 6 months (126/157) were virologically suppressed. International adoptees were more frequently virologically suppressed than other patients (96.0% versus 74.6%, P = 0.02).ConclusionsAntiretroviral coverage exceeded the second UNAIDS 90 target aimed at ending the AIDS epidemic. The rate of virological suppression, one of the highest reported in children in high-income countries, is approaching the third UNAIDS 90 target and the rate observed in French HIV-infected adults on antiretrovirals.     

Vitamin D,cardio-inflammation,and endothelial dysfunction in older adults after orthopedic surgery: Results from an open-label trial to ameliorate cardiac function

ObjectivesAfter orthopedic surgery, clinical outcomes are affected by comorbid cardiovascular diseases (CVDs) and low 25-hydroxy-vitamin D (25-(OH)D). Myocardial function was suggested to be influenced by both the pro-inflammatory cytokine tumour necrosis factor alpha (TNFα) and the marker of endothelial dysfunction asymmetric dimethylarginine (ADMA).Material and methodsWe investigated TNFα and ADMA changes in association with serum levels of vitamin D and cardiac function in 47 older adults after major orthopedic surgery. Subjects were characterized for biochemical profiles and transthoracic echocardiographic measures. Assessments were done before and after the correction of hypovitaminosis D through a 6-month supplementation with calcifediol started at post-operative rehabilitation.ResultsThe means serum levels of both TNFα and ADMA reduced from 1.39 ± 0.47 pg/mL to 1.30 ± 0.37 pg/mL (P < 0.05) and from 0.69 ± 0.05 μmol/L to 0.68 ± 0.04 μmol/L (P < 0.05), respectively. Significant treatment effects were observed for systolic blood pressure (P < 0.05), left ventricular ejection function (P < 0.01), global longitudinal strain (P < 0.0001), 25-(OH)D (P < 0.001), and calcemia (P < 0.001).ConclusionAfter the normalization of low levels of vitamin D, we were able to observe a reduction of circulating TNFα and ADMA together with the amelioration of cardiac function. Even if our results suggest that vitamin D might exert cardiac effects indirectly through the decrease in cardio-inflammation and endothelial dysfunction, a better understanding of the precise molecular regulations should be better investigated.     

Effects of a short term supplementation of a fermented papaya preparation on biomarkers of diabetes mellitus in a randomized Mauritian population

ObjectiveClinical evidence and cellular models have shown an inverse relationship between the intakes of plant and fruit based diets and oxidative stress, suggesting the suitability of natural antioxidants in the management of diabetes mellitus and its complications.MethodA randomized controlled clinical trial was conducted at the Cardiac Centre, SSRN Hospital, Pamplemousses, (Mauritius) to determine the effect of a short term supplementation of a fermented papaya preparation (FPP®) on biomarkers of diabetes and antioxidant status in a multi-ethnical neo-diabetic population from November 2010 to March 2011.ResultSupplementation of 6 g FPP®/day for a period of 14 weeks could improve the general health status of several organs targeted by oxidative stress during diabetes. When comparing experimental to control groups with independent samples t-test, C-reactive protein levels significantly decreased (P = 0.018), LDL/HDL ratio was considerably changed (P = 0.042), and uric acid levels were significantly improved (P = 0.001). ANOVA results also validated the same findings with significant differences in C-reactive protein, LDL/HDL ratio, uric acid and in serum ferritin levels.ConclusionFPP® may present a novel, economically feasible nutraceutical supplement for the management of diabetes and for those at risk for cardiovascular disease, neurological disease and other conditions worsened by overt inflammation and oxidative stress.     

The role of anxiety in the perception of technological hazards – A cross-sectional study on cell phones and masts

BackgroundRisk perception is determined by parameters related to the nature of the risk, as well as inherent to the individual perceiving this risk. This study was designed to provide a better understanding of the role of personality, especially anxiety traits, on risk perception. It compared representations of two different risks, smoking (with known and generally accepted adverse health effects) and cell phones (whose hazardous potency is still controversial), each presented in two different forms of exposure, active (smokers and cell phone users) and passive (passive smoking and exposure to cell phone masts).MethodsA self-administered questionnaire sent to volunteer subjects collected sociodemographic and exposure data. It measured the perceived risk as well as 11 psychometric properties of risk using visual analogue scales (values ranging from 0 to 10). An anxiety trait was evaluated by the Spielberger questionnaire.ResultsIn all, 72% of the questionnaires sent were returned. Mean declared risk scores attributed to passive and active smoking were higher (8.75 and 8.31 respectively) than those attributed to cell phones and masts (4.44 and 4.73 respectively). However, scores for the 11 psychometric properties of the risk attributed to cell phones were higher than those associated with smoking, especially for dissatisfaction with information (6.71 and 7.36 respectively for cell phones and masts versus 1.75 and 2.18 for passive and active smoking) and the capacity of authorities to master the risk (6.45 and 6.65 for cell phones and masts versus 4.72 and 4.40 for passive and active smoking). Anxiety did not directly influence the risk scores attributed to these 4 forms of exposure but was predictive of the way in which subjects perceived the risk in terms of two essential properties: uncertainty concerning the effects on health and the potential to trigger health catastrophes. Indeed anxious subjects are more certain about the hazards of cell phones and masts than non-anxious subjects (P = 0.008 et P ≤ 0.001) and attributed a higher catastrophic potential (P = 0.02 and P = 0.004).ConclusionThis study suggests that subjects with an anxious profile are affected by the destabilizing nature of uncertain knowledge concerning the hazardous potency of new technologies and of the controversies concerning this hazard.