The Efficacy of an Energy-Restricted Anti-Inflammatory Diet for the Management of Obesity in Younger Adults

There is growing evidence of the dietary impact on obesity-induced low-grade chronic inflammation and the associated chronic non-communicable diseases modification. We determined changes in body composition and cardiometabolic and inflammatory status of participants with obesity after 24 weeks of a dietary intervention based on an energy-reduced anti-inflammatory diet and examined the relationship of these changes with changes in the inflammatory potential of the diet. The anthropometric and body composition parameters of 81 participants (average age of 43 years, 74 women) were assessed. Metabolic status was determined using the glycemic and lipid statuses, and the cardiometabolic index and inflammatory status were determined using the concentration of high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α). The inflammatory potential of the diet was assessed using the Dietary Inflammatory Index (DII^®). Intervention with an anti-inflammatory diet resulted in a significant reduction in body weight and visceral adipose tissue and caused improvements in the participants’ cardiometabolic and inflammatory statuses. The anti-inflammatory diet was shown to be effective regarding obesity management. The study data could advance current scientific knowledge in the field of inflammation and diet, provide guidelines for obesity management, and find its application in routine clinical practice.     

Validation of flavonoids as potential dipeptidyl peptidase III inhibitors: Experimental and computational approach

Fifteen flavonoids were studied for their inhibitory activity against human dipeptidyl peptidase III (hDPP III) combining an in vitro assay with an in silico molecular modeling study. All analyzed flavonoids showed inhibitory effects against hDPP III with the IC₅₀ values ranging from 22.0 to 437.2 μm . Our 3D QSAR studies indicate that the presence of hydrophilic regions at a flavonoid molecule increases its inhibitory activity, while the higher percentage of hydrophobic surfaces has negative impact on enzyme inhibition. Furthermore, molecular dynamics (MD) simulations of the complex of hDPP III with one of the most potent inhibitors, luteolin, were performed, and binding mode analysis revealed that the 3′ and 4′ hydroxyl group on B‐ring as well as 5 and 7 hydroxyl group on A‐ring helps luteolin to interact with the Asn391, Asn406, Tyr417, His450, Glu451, Val447, Glu512, Asn545, Gln566, and Arg572 residues. The MD results clearly provide valuable information explaining the importance of flavonoid hydroxyl groups in the mechanism for the binding pattern at the active site of hDPP III.     

The Cardiff Acne Disability Index (CADI): linguistic and cultural validation in Serbian

Purpose

The aims of this study were to translate the Cardiff Acne Disability Index (CADI) into Serbian and to assess its validity and reliability in Serbian acne patients.

Methods

The CADI was translated and linguistically validated into Serbian according to published guidelines. This version of CADI, along with the Serbian version of Children’s Dermatology Life Quality Index (CDLQI) and a short demographic questionnaire, was administrated to a cohort of secondary school pupils. The Global Acne Grading Score was used to measure the clinical severity of acne. The internal consistency reliability of the Serbian version of CADI was assessed by Cronbach’s alpha coefficient while its concurrent validity was assessed by Spearman’s correlation coefficient. Construct validity was examined by factor analysis.

Results

A total of 465 pupils completed questionnaires. Self-reported acne was present in 76% of pupils (353/465). The Serbian version of CADI showed high internal consistency reliability (Cronbach’s alpha coefficient = 0.79). The mean item-total correlation coefficient was 0.74 with a range of 0.53–0.81. The concurrent validity of the scale was supported by a moderate but highly significant correlation with the CDLQI (Spearman’s rho = 0.66; P < 0.001). Factor analysis revealed the presence of two dimensions underlying the factor structure of the scale.

Conclusions

The Serbian version of the CADI is a reliable, valid, and valuable tool for assessing the impact of acne on the quality of life of Serbian-speaking patients.     

Use of maternal health services: comparing refugee,immigrant and US-born populations

Objectives To determine use of recommended maternal healthcare services among refugee and immigrant women in a setting of near-universal insurance coverage. Methods Refugee women age ≥18 years, who arrived in the US from 2001 to 2013 and received care at the same Massachusetts community health center, were matched by age, gender, and date of care initiation to Spanish-speaking immigrants and US-born controls. The primary outcome was initiation of obstetrical care within the first trimester (12 weeks gestation). Secondary outcomes were number of obstetrical visits and attending a postpartum visit. Results We included 375 women with 763 pregnancies (women/pregnancies: 53/116 refugee, 186/368 immigrant, 136/279 control). More refugees (20.6 %) and immigrants (15.0 %) had their first obstetric visit after 12 weeks gestation than controls (6.0 %, p < 0.001). In logistic regression models adjusted for age, education, insurance, BMI, and median census tract household income, both refugee (odds ratio [OR] 4.58, 95 % confidence interval [CI] 1.73–12.13) and immigrant (OR 2.21, 95 % CI 1.00–4.84) women had delayed prenatal care initiation. Refugees had fewer prenatal visits than controls (median 12 vs. 14, p < 0.001). Refugees (73.3 %) and immigrant (78.3 %) women were more likely to have postpartum care (controls 54.8 %, p < 0.001) with differences persisting after adjustment (refugee [OR 2.00, 95 % CI 1.04–3.83] and immigrant [OR 2.79, 95 % CI 1.72–4.53]). Conclusions for Practice Refugee and immigrant women had increased risk for delayed initiation of prenatal care, but greater use of postpartum visits. Targeted outreach may be needed to improve use of beneficial care.     

2-Methoxyestradiol mediates the protective effects of estradiol in monocrotaline-induced pulmonary hypertension

When exposed to chronic hypoxia or toxin monocrotaline (MCT), female animals develop less severe pulmonary arterial hypertension (PH) compared to males; ovariectomy (OVX) exacerbates PH, and OVX animals treated with estradiol (E2) develop less severe disease. There is a line of evidence suggesting that cardiovascular protective effects of E2 are mediated by its major metabolite, 2-methoxyestradiol (2ME). Recently, we have shown that 2ME attenuates the development and retards the progression of MCT-induced pulmonary hypertension in male rats. We hypothesized that the protective effects of E2 in experimental PH are mediated by 2ME. Subsets of intact and OVX female rats were injected saline (Cont and OXV groups) or MCT (60 mg/kg; MCT and OVX-MCT groups) and some of OVX-MCT animals were treated with 2ME (10 microg/kg/h via osmotic minipumps; OVX-MCT+2ME). After 28 days, MCT caused PH, i.e., increased right ventricular peak systolic pressure (RVPSP) and right ventricle/left ventricle+septum (RV/LV+S) ratio, induced inflammatory response in the lungs and caused media hypertrophy (media thickness and % media index) and adventitia widening of small size pulmonary arteries. Ovariectomy exacerbated the disease, i.e., further increased RVPSP, and RV/LV+S ratio, and augmented vascular remodeling and inflammatory response. In diseased OVX rats, treatment with 2ME prevented the worsening of PH and attenuated the inflammatory response and vascular remodeling. No mortality was recorded in the OVX-MCT+2ME group vs. 10% and 36% mortality in the MCT and OVX-MCT group, respectively. This study suggests that 2-methoxyestradiol (a major non-estrogenic metabolite of E2) may mediate the protective effects of estradiol in MCT-induced PH, and warrants further evaluation of 2ME for treatment of PH.     

Th17/Th1 biased immunity to the pneumococcal proteins PcsB, StkP and PsaA in adults of different age

Streptococcus pneumoniae is a major human pathogen, causing high morbidity and mortality in children, and also in the elderly, who are particularly susceptible to S. pneumoniae infections due to the dysregulated function of the aged immune system. As the current generation of polysaccharide vaccines do not provide sufficient protection for elderly, new vaccination strategies are urgently needed.To learn whether pneumococcal proteins are able to induce adaptive immune responses in adults in different age groups, we determined serum IgG antibody titers and T cell immunity (IFN-γ, IL-17A and IL-5 production) to three pneumococcal antigens, PcsB, StkP and PsaA, that are components of an investigational protein-based pneumococcal vaccine, IC47. Therefore, sera and PBMCs of 108 healthy adults in three different age groups (young, middle-aged and elderly) were analyzed by ELISA and ELISpot, respectively.We found naturally acquired antibodies to all three proteins in all age groups against all three antigens. However, elderly individuals had significantly lower IgG levels to PcsB and PsaA compared to those of younger donors. There was no significant age-related difference in the overall rate of T cell immunity for the three pneumococcal proteins. We found that the Th17 response was dominant in all age groups and was frequently combined with a Th1 or Th2 response in young and middle-aged subjects. However, in elderly persons there was a lower percentage of PBMC samples producing more than one cytokine upon antigenic stimulation. The narrow cytokine secretion pattern was the most striking difference between elderly and younger adult age groups.Our results demonstrate that in the majority of adults there is a naturally acquired humoral and cellular immune response to the three pneumococcal proteins tested. The dominance of the Th17 response is especially interesting in the light of new insights regarding the role of Th17 cells in mucosal protection against this pathogen.     

Quantification of wet-work exposure in nurses using a newly developed wet-work exposure monitor

Occupational contact dermatitis (OCD) is an important work-related disease. A major cause of OCD is 'wet work': frequent contact of the skin with water, soap, detergents, or occlusive gloves. The German guidance TRGS 401 recommends that the duration of wet work (including use of occlusive gloves) should not exceed 2 h day(-1) and also the frequency of hand washing or hand disinfection should be taken into account. This highlights the need for a reliable method to assess duration and frequency of wet work. Recently, a wet-work sampler has been developed by the University of Aberdeen. The sampler uses the temperature difference (ΔT) generated by evaporative cooling between two sensors: one sensor on the skin and a second one placed 2 mm above the skin. We have evaluated the use of this sampler in a healthcare setting, using direct observation as reference. Twenty-six nurses wore the sampler on the volar side of the middle finger for ～2 h during their regular daily tasks, while being observed by a researcher. Sampler results were evaluated using various threshold values for ΔT to identify wet events of the hands. The optimal ΔT to discern wet and dry skin differed considerably between individual nurses. Individual results yielded a median sensitivity of 78 and 62% and a median specificity of 79 and 68% for indicating wet skin and glove use, respectively. Overall, the sampler was moderately accurate for identifying wetness of the skin and less accurate for discerning glove use. In conclusion, agreement between observed wet work and device-reported wet events in healthcare settings was not high and further adaptations and developments may be required.     

Chromosomal abnormalities among nurses occupationally exposed to antineoplastic drugs

The effect of handling antineoplastic drugs was examined in 42 nurses working in an oncology department, and the same number of nurses not exposed to antineoplastic drugs acted as controls. The exposure effect was evaluated by analysis of sister chromatid exchanges (SCE) incidence and structural chromosomal abnormalities. SCE as well as chromosomal abnormalities in the exposed group were increased (p less than 0.001 and p less than 0.01, respectively). Sign test for paired sample was used for statistical assessment.