Impact of whole egg intake on blood pressure,lipids and lipoproteins in middle-aged and older population: A systematic review and meta-analysis of randomized controlled trials

Background and aimEffects of whole egg consumption on cardiovascular diseases (CVD) risk in the middle-aged and older population remain unclear due to inconsistent findings from observational and randomized controlled trials (RCTs). This meta-analysis aimed to assess the impacts of whole egg and egg category (whole eggs versus egg substitutes) intake quantity on CVD risk factors from systematically searched RCTs. Egg substitutes were hypothesized to have minimal effects of the blood lipid and lipoprotein profile as they are void of dietary cholesterol.Methods and resultsAs many as 434 studies identified from PubMed, Cochrane Library, CINAHL and Medline (Ovid) databases were screened and data were extracted from 8 selected RCTs. Quality of the selected studies were assessed and the overall effect sizes of weighted mean differences (WMD) were calculated using a random effects model. Non-differential effects in blood pressures, lipids and lipoproteins were observed when >4 whole eggs/week compared to ≤4 whole eggs/week were consumed. Intake of >4 whole eggs/week compared to equivalent amounts of egg substitutes caused greater elevations in blood total cholesterol (WMD: 0.198 mmol/L; 95% CIs: 0.056, 0.339), HDL cholesterol (WMD: 0.068 mmol/L; 95% CIs: 0.006, 0.130) and LDL cholesterol (WMD: 0.171 mmol/L; 95% CIs: 0.028, 0.315) but did not differentially affect triglycerides concentration.ConclusionOverall, the results support the notion that quantity of whole egg intake does not affect CVD risk factors and consuming egg substitutes may also be beneficial compared to whole eggs on lowering CVD risk in the middle-aged and older population.     

六味能消胶囊联合脂必泰胶囊治疗高脂血症的临床研究

目的探讨六味能消胶囊联合脂必泰胶囊治疗高脂血症的临床效果。方法选取2017年5月—2018年10月东营市东营区人民医院收治的64例高脂血症患者,随机分为对照组和治疗组,每组各32例。对照组口服脂必泰胶囊,1粒/次,2次/d。治疗组在对照组治疗基础上口服六味能消胶囊,1粒/次,3次/d。两组均连续治疗8周。观察两组的临床疗效,比较两组治疗前后血脂指标、血流变学指标、血小板参数及血清学指标的变化情况。结果治疗后,对照组和治疗组的总有效率分别是75.0%、96.9%,两组比较差异具有统计学意义(P0.05)。治疗后,两组总胆固醇(TC)、非-HDL-C、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平均较治疗前显著降低,而高密度脂蛋白胆固醇(HDL-C)显著升高,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组TC、非-HDL-C、TG、LDL-C水平低于对照组,而HDL-C高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血浆黏度(PV)、红细胞比容(HCT)、聚集指数(RCAI)、平均血小板体积(MPV)、血小板最大聚集率(MAR)均显著降低,而变形指数(RDI)值均显著升高,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,PV、HCT、RCAI、MPV、MAR值均显著低于对照组,而RDI值高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清C反应蛋白(CRP)、内皮素(ET)水平较治疗前均显著降低,而一氧化氮(NO)水平显著增高,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组CRP、ET水平低于对照组,而NO水平高于对照组,两组比较差异有统计学意义(P0.05)。结论六味能消胶囊联合脂必泰胶囊治疗高脂血症具有较好的临床疗效,综合调脂作用显著,可明显纠正患者体内血流变学异常,改善血小板功能及微炎症状态,保护血管内皮功能,具有一定的临床推广应用价值。     

Influence of tooth clench on the soleus H-reflex

The Hoffmann (H) reflex is elicited by electrical stimulation of a mixed nerve and is used to measure the excitability of the spindle-motoneuron synapse. Recent investigations have indicated a positive correlation between increases in bite force and H-reflex facilitation. However, these investigations did not examine the H-reflex in detail or the possible role of periodontal mechanoreceptors (PMRs) in this facilitation. The current investigation was performed to determine whether PMRs play a role in H-reflex facilitation during tooth clench (TC). The H-reflex was elicited in the soleus muscle of human subjects while bite level was maintained at rest (0 N), 40 N, 80 N and maximal TC. The front teeth that contributed to the (40 N and 80 N) bite force were then locally anaesthetised (LA), and the protocol was repeated. The current data suggest that the effect of TC on the H-reflex amplitude in the human limb muscles is variable from one subject to the next. Statistical analysis has shown that the H-reflex was significantly smaller during the rest condition than during the 80 N bite (p<0.05) in both non-LA and LA conditions. Since LA did not alter the response, our results do not support that the PMRs play a major role in the facilitation of distal muscle activity.     

Exploring the relationship between cognitive illness representations and poor emotional health and their combined association with diabetes self-care. A systematic review with meta-analysis

Objective

Depression and anxiety are common in diabetes and are associated with lower diabetes self-care adherence. How this occurs is unclear. Our systematic review explored the relationship between cognitive illness representations and poor emotional health and their combined association with diabetes self-care.

Methods

Medline, Psycinfo, EMBASE, and CINAHL were searched from inception to June 2013. Data on associations between cognitive illness representations, poor emotional health, and diabetes self-care were extracted. Random effects meta-analysis was used to test the relationship between cognitive illness representations and poor emotional health. Their combined effect on diabetes self-care was narratively evaluated.

Results

Nine cross-sectional studies were included. Increased timeline cyclical, consequences, and seriousness beliefs were associated with poorer emotional health symptoms. Lower perceived personal control was associated with increased depression and anxiety, but not mixed anxiety and depressive symptoms. Remaining cognitive illness representation domains had mixed statistically significant and non-significant relationships across emotional states or were measured only once. Effect sizes ranged from small to large (r = ± 0.20 to 0.51). Two studies explored the combined effects of cognitions and emotions on diabetes self-care. Both showed that cognitive illness representations have an independent effect on diabetes self-care, but only one study found that depression has an independent effect also.

Conclusions

Associations between cognitive illness representations and poor emotional health were in the expected direction — negative diabetes perceptions were associated with poorer emotional health. Few studies examined the relative effects of cognitions and emotions on diabetes self-care. Longitudinal studies are needed to clarify directional pathways.     

D-dimer relates positively with increased blood pressure in black South Africans: The SABPA study

Introduction

Hypertension is highly prevalent in black South Africans in which morbidity and mortality from stroke are on the increase. Elevated blood pressure and haemostatic markers can induce changes in blood rheology and endothelial function which could result in a procoagulant state that increases the risk for cerebrovascular disease. Information about the coagulation and fibrinolytic systems of people from African descent are limited. We therefore, investigated the haemostatic profile and its relationships with blood pressure in black South Africans.

Materials and methods

We measured ambulatory blood pressure and haemostatic markers of 201 black and 208 white school teachers. The haemostatic markers included measurements representing coagulation and fibrinolysis (von Willebrand factor, fibrinogen, plasminogen activator inhibitor-1, fibrin D-dimer and clot lysis time).

Results

Black participants displayed significantly higher blood pressure, von Willebrand factor, fibrinogen, plasminogen activator inhibitor-1 and D-dimer levels and longer clot lysis times (p ≤ 0.001). Single, partial and multiple regression analyses showed that systolic (p ≤ 0.011) and diastolic blood pressure (p = 0.010) correlated positively with D-dimer in black participants, while systolic (p ≤ 0.001) and daytime diastolic blood pressure (p = 0.011) correlated negatively with clot lysis time in white participants.

Conclusion

The black population had a more prothrombotic profile, with higher levels of coagulation markers and inhibited fibrinolysis, than the white study participants. The positive association between blood pressure and elevated D-dimer in the blacks may contribute to the high prevalence of hypertension and related increased cardiovascular and cerebrovascular risk in this group.     

Decreased small dense LDL levels in Gilbert's syndrome

Objective

To investigate the role of small dense low density lipoprotein cholesterol (sd-LDL-C) in the mechanism of decreased incidence of cardiovascular disease in Gilbert's syndrome (GS).

Design and methods

sd-LDL-C, ox-LDL, and high sensitive C reactive protein (hs-CRP) levels were investigated in subjects with GS (n = 42) and compared to healthy controls (n = 52).

Results

Age, gender and body mass index (BMI) distributions were similar between the two groups. sd-LDL-C, ox-LDL and hs-CRP levels were lower in GS than the healthy controls (p < 0.001, p < 0.001 and p = 0.001, respectively). Unconjugated bilirubin was negatively correlated with sd-LDL-C, ox-LDL and hs-CRP (r = −0.594, p < 0.001; r = −0.249, p = 0.016 and r = − 0.373, p < 0.001 respectively). In addition, sd-LDL-C was positively correlated with ox-LDL (r = 0.307, p = 0.003).

Conclusions

The findings of this preliminary study suggest that reduced sd-LDL-C, ox-LDL and hs-CRP levels may have a role in preventing atherosclerosis in subjects with GS.     

Ileocolic intussusception: Predicting the probability of success of ultrasound guided saline enema from clinical and sonographic data

Background/purpose

To identify factors that dim the efficacy of ultrasound guided saline enema (USGSE) and to design a mathematical model for predicting the probability of success of USGSE.