Associations between the Nutrient Profiling System Underlying the Nutri-Score Nutrition Label and Biomarkers of Chronic Low-Grade Inflammation: A Cross-Sectional Analysis of a Middle- to Older-Aged Population

Low-grade systemic inflammation is associated with a range of conditions. Diet may modulate inflammation and public health strategies are needed to guide consumers’ dietary choices and help prevent diet-related disease. The Food Standards Agency nutrient profiling system (FSAm-NPS) constitutes the basis of the five-colour front-of-pack Nutri-Score labelling system. No study to date has examined FSAm-NPS dietary index associations with biomarkers of inflammation. Therefore, our objective was to test relationships between the FSAm-NPS and a range of inflammatory biomarkers in a cross-sectional sample of 2006 men and women aged 46–73 years. Individual participant FSAm-NPS scores were derived from food frequency questionnaires. Pro-inflammatory cytokine, adipocytokine, acute-phase response protein, coagulation factor and white blood cell count concentrations were determined. Correlation and linear regression analyses were used to examine FSAm-NPS relationships with biomarker levels. In crude and adjusted analyses, higher FSAm-NPS scores, reflecting poorer nutritional quality, were consistently and positively associated with biomarkers. In fully adjusted models, significant associations with concentrations of complement component 3, c-reactive protein, interleukin 6, tumour necrosis factor alpha, resistin, white blood cell count, neutrophils, eosinophils and the neutrophil-to-lymphocyte ratio persisted. These results suggest that dietary quality, determined by Nutri-Score rating, is associated with inflammatory biomarkers related to health.     

Necrotizing enterocolitis: early conventional and fluorescein laparoscopic assessment

Aim

The clinical and radiological diagnosis of necrotizing enterocolitis (NEC) can be difficult. When radiological evidence is present, severity and complications, such as perforation and full-thickness necrosis, often may not be obvious. This study aims to establish early signs of full-thickness necrosis or perforation by using standard and fluorescein laparoscopy before clinical deterioration of patients occurs.

Patients and Methods

Thirteen patients with preoperative presumed clinical and/or radiological diagnosis of NEC underwent laparoscopy. A 4.7-mm umbilical or left upper quadrant camera port was inserted by using the open method. The abdominal cavity was inspected for bowel ischemia, fibrin, adhesion formation, and presence of free intestinal contents. If necessary, one or two 3-mm working ports were inserted for manipulation of bowel.

Results

Median age of 13 patients was 17 (3-38) days. Their median weight was 1160 (910-2415) g. The first 5 infants had standard laparoscopy only, with the next 8 having fluorescein-aided assessment added to the laparoscopy. Standard laparoscopy identified perforation in 5 patients and gangrenous bowel in 2. One patient was found to have chyle ascites, and 1 patient had no abnormal findings on laparoscopy. Fluorescein identified gangrenous bowel in 3 additional patients. Laparotomy and necessary surgical intervention were performed in all 10 patients with positive laparoscopy findings. Eleven patients survived and were doing well at a median of 9 (range, 6-39) months of follow-up.

Conclusion

Laparoscopy helps to improve assessment of patients with a diagnosis of NEC. It allows for early identification of perforation and necrosis. Where ischemia is suspected, fluorescein laparoscopy may have an added benefit in identifying necrotic segments.     

Emergence of CA125 immunoreactivity in recurrent or metastatic primary ovarian mucinous neoplasms of the intestinal type

Primary ovarian mucinous carcinomas are uncommon and usually present as unilateral stage 1 neoplasms. The vast majority are of the so-called intestinal or enteric type and arise from a preexisting intestinal-type mucinous borderline neoplasm. The overall prognosis is good. However, a minor proportion recurs or metastasizes, and this is associated with a poor prognosis. The vast majority of primary ovarian intestinal-type mucinous carcinomas and borderline tumors exhibit a variable degree of positivity with enteric markers and are CA125 negative. The primary purpose of this study was to describe the unusual phenomenon of CA125 immunoreactivity in 8 of 10 metastatic mucinous carcinomas arising after a diagnosis of primary ovarian mucinous carcinoma (n=3) or mucinous borderline tumor of the intestinal type (n=7) in which the primary neoplasms were mostly negative. The reasons underlying this emergent CA125 positivity are not clear, but we speculate it may be because while intestinal type mucinous borderline neoplasms and mucinous carcinomas exhibiting so-called expansile invasion are usually CA125 negative, focal positivity may be seen in areas of infiltrative stromal invasion, which may preferentially metastasize. CA125 positivity in the metastatic neoplasm may result in the pathologist considering an alternative primary site; however, this should not be the case. In our study, we found a 4.2% risk of malignant progression after a diagnosis of primary ovarian mucinous borderline tumor of the intestinal type. In light of this, we favor retaining the term "mucinous borderline tumor," because of this small, but not insignificant, risk of malignant transformation, which in most cases is likely secondary to a focus of invasion being unsampled at the time of reporting the primary neoplasms.     

Is residual impairment after alcohol an effect of repeated performance?

BACKGROUND: The study examines the residual impairment of performance due to alcohol on the descending limb of the blood alcohol curve. The occurrence of residual impairment at low or zero levels of blood alcohol is well established but its cause is uncertain. It is hypothesized that residual impairment may be due in part to the methodological procedure of repeated performance testing in the post-ingestion period. METHODS: There were 80 volunteers randomly allocated to one of four treatment conditions: a) alcohol and repeated performance (A-R) where psychomotor tasks were performed at 20-min interval for 2 h post ingestion; b) alcohol and double performance (A-D) where tasks were performed only at 1 h and 2 h from ingestion; c) placebo and repeated performance (P-R); and d) placebo and double performance (P-D). Alcohol was administered as vodka to achieve a peak blood-alcohol concentration (BAC) of approximately 80 mg per 100 ml. Performance effects were assessed by a dual task of primary pursuit tracking and secondary visual reaction time, and a visual sustained attention task. RESULTS: Alcohol caused significant impairment of secondary reaction time, the effect being greatest at peak BAC. Sustained attention was also impaired by alcohol but the effect just missed significance. Repeated performance conditions were associated with significantly greater impairment of secondary reaction time and sustained attention when compared with double performance conditions. The factor of performance condition did not, however, interact with that of alcohol. CONCLUSIONS: The monotony and boredom that may be associated with repeated performance do not contribute to residual alcohol impairment.     

Cerebral hypoperfusion in immediate postoperative period following coronary artery bypass grafting, heart valve, and abdominal aortic surgery

Perioperative levels of jugular bulb oxyhaemoglobin saturation(Sj_O2) and lactate concentration (Lj), and postoperative durationof Sj_O2<50% were compared between patients undergoing coronaryartery bypass grafting (CABG) (n=86), heart valve (n=14) andabdominal aortic (n=16) surgery. Radial artery and jugular bulbblood samples were aspirated after induction of anaesthesia,during re-warming on cardiopulmonary bypass (CPB) (36°C),on arrival in the intensive care unit (ICU) and, subsequently,at 1, 2 and 6 h after ICU admission. Most patients having heartsurgery were hypocapnic at 36°C on CPB. Following CABG andheart valve surgery, many patients were hypocapnic whereas afterabdominal aortic surgery, most were hypercapnic. During CPBand postoperatively, Sj_O2 and Lj were significantly correlatedto Pa_CO2 and the arterial concentration of lactate (La) respectively(P<0.05). After correction for arterial carbon dioxide tension(Pa_CO2) and La, there were no significant changes in Sj_O2 orLj on CPB. Postoperatively, having corrected for Pa_CO2, therewere significant effects on Sj_O2 over all groups as a resultof time from surgery (P<0.001) and its interaction with operationtype (P<0.001). Following correction for La, there were nopostoperative effects on Lj. No significant differences (P=0.2)in duration of Sj_O2<50% existed between patients undergoingCABG (1054 (82) min), abdominal aortic (893 (113) min) and heartvalve (1073 (91) min) surgery. The lack of significant reciprocaleffects on Lj combined with the frequency of hypocapnia andstrong influence of Pa_CO2on Sj_O2, suggest that Sj_O2<50% duringCPB and after cardiac surgery represents hypoperfusion as aconsequence of hypocapnia rather than cerebral ischaemia. Br J Anaesth 2001; 87: 229–36     

Exclusion of known gene for enamel development in two Brazilian families with amelogenesis imperfecta

Background

Functional rehabilitation of patients afflicted with severe mandibular and maxillary alveolar atrophy might be challenging especially in malformed patients.

Methods

Treatment planning using sinus lifting and implant placement before Le Fort I maxillary osteotomy in a patient with severe mandibular and posterior maxillary alveolar atrophy and skelettal class-III conditions due to cleft palate are described.

Results

A full functional and esthetic rehabilitation of the patient was achieved by a stepwise surgical approach performed through sinus lifting as the primary approach followed by implant placement and subsequent Le Fort I maxillary osteotomy to correct the maxillo-mandibular relation.

Conclusion

Stabilisation of the maxillary complex by a sinus lifting procedure in combination with computer aided implant placement as preorthodontic planning procedure before Le Fort I maxillary osteotomy seems to be suitable in order to allow ideal oral rehabilitation especially in malformed patients.