Dietary fat intake and metabolic syndrome in adults: A systematic review

Background and aimsThe metabolic syndrome (MetS) is a cluster of coexisting cardiovascular risk factors. The role of specific dietary fats was reemphasized by dietary recommendations. This systematic review aims to assess evidence for the effect of dietary fat intake on MetS occurrence and reversion in adults.Methods and ResultsThe MEDLINE database was used to search the existing literature. We included observational studies that analyzed dietary fat intake in adults with MetS and clinical trials that compared the effects of different dietary fat diets on MetS and/or its components. Thirty articles were selected (14 observational and 16 clinical trials), and we included information of dietary fat and fatty acids as well as MetS, body mass index, cholesterol, hypertension, and diabetes in adults. SFA intake was found to be positively associated with MetS components. Most of the observational reviewed studies found beneficial associations between MUFA and PUFA (including n-3 and n-6 subtypes) intake and MetS components. Clinical trials also supported the benefits of MUFA- or PUFA-enriched diets (including low-fat diets) in reducing MetS.ConclusionsThe effects of dietary SFAs on MetS will be influenced by other specific nutrients. Replacement of SFA by MUFA and PUFA has been associated with a decrease in MetS. Dietary recommendations should emphasize on different qualities of fat intake, not only to reduce total fat intake, to obtain health benefits in adults.     

Lasting effects of stress physiology on the brain: Cortisol reactivity during preschool predicts hippocampal functional connectivity at school age

Prolonged exposure to glucocorticoid stress hormones, such as cortisol in humans, has been associated with structural and functional changes in the hippocampus. The majority of research demonstrating these associations in humans has been conducted in adult, clinical, or severely maltreated populations, with little research investigating these effects in young or more typically developing populations. The present study sought to address this gap by investigating longitudinal associations between preschool (3−5 years) and concurrent (5–9 years) cortisol reactivity to a laboratory stressor and hippocampal functional connectivity during a passive viewing fMRI scan. Results showed that, after controlling for concurrent cortisol reactivity, greater total cortisol release in response to a stressor during preschool predicted increased anterior and posterior hippocampal connectivity with the precuneus and cingulate gyrus at school-age. These findings are consistent with literature from adult and non-human investigations and suggest lasting impacts of early stress physiology on the brain.     

Post-traumatic stress disorder and its risk factors in bereaved Tibetan adolescents 3 years after the 2010 Yushu earthquake,a cross-sectional study in China

Objectives

This study examined the incidence of symptomatological post-traumatic stress disorder (PTSD) in bereaved Tibetan adolescents 3?years after the 2010 Yushu earthquake, then to identify possible and relational risk factors of PTSD by a cross-sectional study.

Part II: presentation,diagnosis, classification,treatment, and prevention of stress fractures in female athletes

ABSTRACT

Objectives: Stress fractures (SFx) occur as the result of repetitive loads over short periods of time, which leads to micro-damage of the bone through cortical resorption, ultimately leading to fracture. They are a common injury in female athletes and often cause significant morbidity. The goal of this study is to review the presentation, diagnosis, classification, treatment, and prevention of SFx in female athletes.

Results: A thorough history, physical exam, and appropriate imaging can facilitate early diagnosis of stress fracture (SFx) and faster resolution of symptoms with more conservative management. The female athlete triad is an especially important factor that contributes to the increased risk of SFx in females. The continuum of stress injuries ranges from mild microfailure to complete fracture, which has resulted in the development of newer grading schemas through MRI and radiographic findings. Stress fractures are also classified as low- or high-risk according to anatomic location, as blood supply and applied forces at different locations affect the likelihood of fracture propagation, displacement, delayed union, or non-union.

Conclusions: The ability to screen for at-risk athletes is paramount in preventing SFx. Recognition and prompt treatment of the female athlete triad requires a multidisciplinary approach in order to restore energy balance, correct menstrual irregularities, and improve bone health. This review provides a basis for understanding how to identify and treat stress fractures, which may allow treating physicians to diagnose this condition earlier and minimize any associated morbidity.     

The fatty acid amide hydrolase inhibitor URB597 modulates splenic catecholamines in chronically stressed female and male rats

The changes in sympathetic innervations in lymphoid organs could be a key factor in immune dysregulation. The endocannabinoid system has been shown to exhibit potent immunomodulatory effects that may differ between males and females, representing a potential therapeutic target for peripheral and central inflammatory disorders. Thus, in the present study, an examination was made of the effect of fatty acid amide hydrolase inhibitor URB597 treatment on splenic catecholamine content, synthesis, uptake and degradation in chronically unpredictably stressed (CUS) female and male rats. The results show that CUS increases anxiety-like behaviors and that URB597 had an anxiolytic effect on chronically stressed animals of both sexes. CUS induced the expression of plasma interleukin – 6 (IL-6), interleukin – 10 (IL-10) and IL-6 in the spleen, whereas the expression of IL-10 was reduced in the spleen of both sexes. URB597 treatment did not cause changes in IL-6 in plasma or the spleen, whereas it increased IL-10 in the spleen in CUS animals of both sexes. CUS caused a significant depletion of noradrenaline content in the spleen of female rats and a reduction in noradrenaline uptake in the spleen of female rats, while stressed males had a small but insignificant decrease of splenic noradrenaline levels and an enhanced uptake. The FAAH inhibitor URB597 enhances reduced noradrenaline content, affecting its uptake directly at the level of the spleen. It gives rise to the possibility that endocannabinoids exert a neurorestorative effect on the sympathetic nerve system and cell-mediated immune responses in the spleen of chronically stressed rats.     

Cutoff score of the traditional Chinese version of the short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire (PISQ-12)

ObjectiveThe short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) is a condition-specific instrument used to evaluate sexual function in women with pelvic floor disorders. The traditional Chinese version of the PISQ-12 (CVPISQ-12) has been validated, however the cutoff score has yet to be determined. The aim of this study is to establish the cutoff score for the CVPISQ-12 and analyze the risk factors for female sexual dysfunction.Material and methodsA sub-analysis of data involving sexually active women who sought consultation for pelvic floor disorders at a medical center in 2016. Based on the known cutoff value of Female Sexual Function Index, the cutoff score of the CVPISQ-12 was analyzed using receiver operating characteristic (ROC) curve analysis. Other assessments included 1-h pad test and incontinence-related questionnaires using the short forms of the Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7).ResultsROC curve analysis showed a cutoff score of 32.5, with a sensitivity of 87% and specificity of 88%. The area under the ROC curve was 0.937 (p <0.001; 95% confidence interval: 0.895–0.979). The 1-h pad test (B = −0.266; p = 0.031), IIQ-7 (B = −0.378; p = 0.047) and age (B = −0.415; p = 0.001) were risk factors for sexual dysfunction in women with a score <32.5. However, age was the only significant risk factor for women with a higher score (B = −0.384; p = 0.035).ConclusionsA CVPISQ-12 score ≥32.5 suggested normal sexual function. For this patient group, age may be a more important factor associated with sexual function than pelvic floor disorders.     

不同时间电针对直肠癌开腹手术患者围术期应激反应和免疫功能的影响

目的观察不同时点电针对直肠癌开腹手术患者围术期应激反应及免疫功能的影响。方法240例择期行直肠癌根治性开腹手术而住院的患者,随机分为A组、B组、C组、D组,每组60例。A组设为空白对照组,B组于手术前1 d、C组于手术前1 d和麻醉诱导前30 min、D组分别于手术前1 d、麻醉诱导前30 min及手术后1 d行电针。分别于手术前1 d电针前(T1)、麻醉诱导前电针前(T2)、术毕(T3)和手术后1 d电针后(T4)4个时间采集患者空腹外周静脉血,用Sysmex血细胞分析仪对白细胞与中性粒细胞进行计数;ELISA检测急性期C反应蛋白(CRP)与热反应蛋白70(HSP70)以及细胞因子白介素6(IL-6)、干扰素(IFN-g)、白介素4(IL-4)水平,并计算IFN-g与IL-4比值;采用流式细胞仪测定CD4、CD8的细胞含量并计算两者比值。结果HSP70与CRP水平、白细胞数与中性粒细胞数、IL-4与IL-6水平变化趋势均一致,4组T1、T2时间比较,差异无统计学意义(P>0.05);A组与B组T3和T4时间比较,差异无统计学意义(P>0.05);C组、D组T3和T4时间显著低于A组与B组(P<0.05);D组T4时间显著低于C组(P<0.05);4组T2时间与T1时间比较差异无统计学意义(P>0.05),T3时间高于T2时间(P<0.05),T4时间低于T3时间(P<0.05)。IFN-g变化不显著(P>0.05),IFN-g/IL-4、CD4/CD8变化趋势与以上相反。结论电针术前使用对直肠癌患者无显著疗效,但能够减轻术后应激反应和免疫抑制,并且随着电针次数的合理增加疗效更加显著。