Ultra-Processed Food Consumption and Adult Diabetes Risk: A Systematic Review and Dose-Response Meta-Analysis

(1) Background: Recent individual studies have demonstrated that consumption of ultra-processed food (UPF) may be related to type two diabetes mellitus (T2DM). We aimed to synthesize the results from these individual studies by conducting an updated systematic review and meta-analysis of observational studies evaluating the association between UPF consumption and the risk of T2DM. (2) Methods: A systematic search was conducted using ISI Web of Science, PubMed/MEDLINE and Scopus electronic databases from inception up to August 2021. Data were extracted from five studies (one cross-sectional study and four cohort studies, totaling 230,526 adults from four different countries). Risk ratios (RR) of pooled results were estimated using a random-effects model. (3) Results: Our results revealed that higher UPF consumption was significantly associated with an increased risk of T2DM (RR = 1.74; 95% CI: 1.36, 2.22; I² = 68.9%; p < 0.001; n = 5). Linear dose-response analysis indicated that each 10% increase in UPF consumption (kcal/d) was associated with a 15% higher risk of T2DM (RR = 1.15; 95% CI: 1.06, 1.26; I² = 86.0%; p < 0.001; n = 5) among adults. Non-linear dose-response analysis demonstrated a positive linear association between UPF consumption and T2DM (p_nonlinearity = 0.13, p_{dose-response} < 0.001; n = 5) among adults. (4) Conclusions: A higher intake of UPF was significantly associated with an increased risk of T2DM. However, underlying mechanisms remain unknown and future experimental studies are warranted.     

The Association between Vitamin D and Zinc Status and the Progression of Clinical Symptoms among Outpatients Infected with SARS-CoV-2 and Potentially Non-Infected Participants: A Cross-Sectional Study

Vitamin D and zinc are important components of nutritional immunity. This study compared the serum concentrations of 25-hydroxyvitamin D (25(OH)D) and zinc in COVID-19 outpatients with those of potentially non-infected participants. The association of clinical symptoms with vitamin D and zinc status was also examined. A checklist and laboratory examination were applied to collect data in a cross-sectional study conducted on 53 infected outpatients with COVID-19 and 53 potentially non-infected participants. Serum concentration of 25(OH)D were not significantly lower in patients with moderate illness (19 ± 12 ng/mL) than patients with asymptomatic or mild illness (29 ± 18 ng/mL), with a trend noted for a lower serum concentration of 25(OH)D in moderate than asymptomatic or mild illness patients (p = 0.054). Infected patients (101 ± 18 µg/dL) showed a lower serum concentration of zinc than potentially non-infected participants (114 ± 13 µg/dL) (p = 0.01). Patients with normal (odds ratio (OR), 0.19; p ≤ 0.001) and insufficient (OR, 0.3; p = 0.007) vitamin D status at the second to seventh days of disease had decreased OR of general symptoms compared to patients with vitamin D deficiency. This study revealed the importance of 25(OH)D measurement to predict the progression of general and pulmonary symptoms and showed that infected patients had significantly lower zinc concentrations than potentially non-infected participants.     

Synthesis and antihypertensive activity of 1-(2-thiazolyl)-3, 5-disubstituted -2-pyrazolines

Several substituted 3-aryl-1-(4-aryl-2-thiazolyl)-5-(3-pyridyl)-2-pyrazolines were synthesized by reacting substituted 3-aryl-5-(3-pyridyl)-1-thiocarbamoyl-2-pyrazolines with phenacyl bromide in ethanol. The structures of all compounds were confirmed by IR, (1)H-NMR, mass spectral data and elemental analyses. The antihypertensive activity of compounds was examined by the tail-cuff method and compared with clonidine. Compounds 24-28 showed significant antihypertensive activity.     

An age-integrated approach to improve measurement of potential spatial accessibility to emergency medical services for urban areas

Objective: This study aimed to develop an age-included approach to measure the potential accessibility to Emergency medical services (EMS) across urban and suburban areas of Mashhad city in Iran. Methods: We used an improved version of two-step floating catchment area (2SFCA) and enhanced 2SFCA (E2SFCA) methods to measure the potential accessibility to EMS services with inclusion of age factor. This enabled us to better model accessibility of the older population to the EMS. We used 22 800 records of EMS enquiries from July to September 2018 to evaluate and assess the potential improvement in access to the EMS with incorporating age in the model. Results: Suburb areas had less potential accessibility compared with central urban due to the high density of EMS stations in the city center areas. Our model showed slight improvement in potential accessibility measurement as a result of the proposed age-integrated method. Conclusion: An age-integrated index of accessibility method takes into account the age distribution of the population in service area is highly associated with actual measures of accessibility to EMS services. Identifying areas with poor access to EMS will help policymakers to design better policy planning to allocate resources and improve provision of EMS services.     

Evaluation of the Inter and Intra-Observer Reliability of the AO Classification of Intertrochanteric Fractures and the Device Choice (DHS,PFNA, and DCS) of Fixations

BackgroundArbeitsgemeinschaftfürOsteosynthesefragen (AO) classification is the most frequently used tool to classify intertrochanteric fractures. However, there is limited evidence regarding its reliability. Therefore, this study was designed to evaluate inter-observer and intra-observer reliability of the AO-2018 intertrochanteric fracture classification.MethodA retrospective study was conducted in Imam Khomeini Hospital Complex, on radiography of patients who came with intertrochanteric fractures from March 21, 2018, to March 19, 2019. Four orthopedic trauma surgeons assessed 96 anteroposterior pelvic radiographs of intertrochanteric fractures and classified using an AO intertrochanteric fracture classification of 2018. The reading and review of radiography were performed in 2 separate occasions in a 1-month interval. The inter-observer and intra-observer reliability was assessed using kappa statistics.ResultThe level of both mean inter-observer (K =0.322; 95%CI: 0.321–0.323) and intra-observer agreement (K =0.317; 95%CI: 0.314–0.320) in AO intertrochanteric fracture classification subgrouping were not satisfactory. The inter-observer (K =0.61; 95%CI: 0.608–0.611) and intra-observers'' (K=0.560; 95%CI: 0.544–0.566) reliability in AO main groupings showed moderate agreement.ConclusionThe AO classification does not show adequate and acceptable inter-observer and intra-observer reliability and reproducibility. Therefore, it will be hard to base on the AO classification for treatment protocols.     

Effects of Pistacia atlantica on Oxidative Stress Markers and Antioxidant Enzymes Expression in Diabetic Rats

Introduction: Diabetes mellitus (DM) affects many patients all over the world. It involves different parts of the body, such as brain, eyes, kidneys, vessels, and so on. The lack of balance between free radicals and antioxidants is a possible mechanism involved in the pathogenesis of diabetes. Antioxidant treatment, especially natural forms, can be a beneficial solution. Therefore, we evaluated the effects of Pistacia atlantica oleoresin (PAO) on oxidative stress markers and antioxidant enzymes expression in diabetic rats.

Method: Fifty adult male Wistar rats were allotted randomly into five groups as follow: control group, diabetic control group, glibenclamide control group, diabetic glibenclamide group, diabetic treated group with 200?mg/kg PAO. Then PAO was prepared and analyzed by gas chromatography/mass spectroscopy (GC/MS). LD50 was also estimated for essential oil. Oxidative stress markers and antioxidant enzyme including malondialdehyde (MDA), glutathione (GSH), glutathione peroxidase (GPx), catalase (CAT), and superoxide dismutase (SOD) were also measured. The expression of GPx, CAT, and SOD genes was investigated using real-time polymerase chain reaction (PCR).

Results: The main constituents of essential oil gum were beta-pinene (29.38%), followed by alpha-pinene (18.15%), myrcene (7.36%), trans-pinocarveol (7.15%), and camphene (4.12%). Diabetes induced an increased level of MDA (69.92?±?3.92 vs. 43.76?±?3.73) and decreased levels of GSH (2.57?±?0.40 vs. 7.05?±?1.59), GPx (11.66?±?2.2 vs. 16.38?±?2.1), CAT (12.17?±?3.38 vs. 18.7?±?2.66), and SOD (0.78?±?0.67 vs. 2.41?±?0.46). In contrast, PAO treatment significantly decreased MDA (54.59?±?12.54 vs. 69.92?±?3.92) and increased GSH (4.5?±?0.89 vs. 2.57?±?0.40), GPx (25.86?±?5.37 vs. 11.66?±?2.2), CAT (22.69?±?0.36 vs. 12.17?±?3.38), and SOD (3.65?±?1.08 vs. 0.78?±?0.67) (p?<?0.05). Moreover, our results indicated that both GPx and CAT mRNA levels significantly increased approximately 4.46 and 6.23 times in rats fed with 200?mg/kg of PAO, more than that of the healthy control group, respectively (p?<?0.01 and p?<?0.001, respectively). Also, the average expression level of SOD was also significantly 1.57 higher in rats fed with 200?mg/kg of PAO in comparison to the diabetic control group (p?<?0.05).

Conclusion: The results indicated that PAO could be propose as an agent that protects the body against diseases that are associated with oxidative stress.     

Spezifische physiologische und unspezifische psychische Effekte bei der Akupunkturtherapie des Reizdarmsyndroms: Ergebnisse einer randomisierten kontrollierten Studie

Background and aims

The aim was to evaluate the efficacy of acupuncture (AC) in patients with irritable bowel syndrome (IBS). We investigated psychological and neuroendocrinological parameters to meet the demands of the psychosomatic paradigm. In addition, we wanted to examine the impact of perception of bodily sensations on treatment response.

Methods

43 patients with IBS were randomly assigned to receive either AC (n = 22) or sham acupuncture (SAC) (n = 21) using the ”Streitberger needle„. Primary outcome measure was quality of life (QoL) measured with the functional digestive diseases quality of life questionnaire (FDDQL) and a general quality of life questionnaire (SF-36). QoL was measured before AC treatment (t1), after ten treatment sessions (t2) and three months after treatment (t3). Secondary outcome measures were parameters of the autonomic nervous system (ANS) which were evaluated with tilt-table manoeuvres at t1 and t2. Additionally, salivary cortisol was measured at t1 ant t2. Perception of bodily sensation was measured at t1 with the ”Perception of Bodily Sensation„ (PBS) questionnaire.

Results

QoL improved in both groups (p = 0,022). However, there were no group differences in QoL improvements between AC and SAC. Salivary cortisol decreased in both groups (F = 10,55; p = 0,006). However, the decrease was more pronounced in the AC group (F = 4,07; p = 0,033). Heart rate response decreased during orthostatic stress in the AC group while it increased in the SAC group (group difference: F = 9,23; p = 0,005), indicating an increased parasympathetic tone in the AC group. Improvement of pain was positively associated with increased parasympathetic tone in the AC group (r² =0,40; F = 10,1; p = 0,006), but not in the SAC group. High PBS was associated with lower QoL before and after treatment (p = 0,033).

Conclusions

The psychosomatic study design made it possible to detect differentiated acupuncture effects. QoL improvement seems to be due to unspecific effects and physiological changes are likely to be induced specifically by AC. Thus, different mechanisms may be involved in sham and real-AC mediated improvements. Patients with high PBS show a more unfavourable course of treatment independently of the kind of acupuncture treatment.