Platelet reactivity in male smokers following the acute consumption of a flavanol-rich grapeseed extract

Epidemiological studies suggest that a high dietary intake of flavanols, a subclass of flavonoids, is associated with reduced risk of vascular disease. Clinical studies have also shown that the consumption of certain flavanol-rich foods (e.g., cocoa, tea, red wine), as well as intake of the individual flavanol (-)-epicatechin, can result in improvement in a number of parameters associated with vascular disease, including improved endothelial function, reduced platelet reactivity, and reduced oxidative stress. The present study assessed the effects of a flavanol-rich supplement on platelet reactivity and plasma oxidant defense in a group of smokers, a population at an elevated risk for vascular disease. Male smokers were randomly assigned to a placebo (n = 10) or a flavanol-rich grapeseed extract (FRGSE; n = 13) group, and after an overnight fast, blood samples were collected before and at 1, 2, and 6 hours following consumption of the placebo or supplement. The FRGSE supplement, but not the placebo, significantly decreased ADP-stimulated platelet reactivity at 1, 2, and 6 hours following intake (P < .05) compared to baseline levels. Similarly, the supplement, but not the placebo, decreased epinephrine-stimulated platelet reactivity 2 hours following consumption. Plasma antioxidant capacity (total radical trapping antioxidant potential), lipid oxidation (plasma thiobarbituric acid-reactive substances), and serum uric acid concentrations were not affected in either group. Thus smokers may obtain some health benefits from the consumption of certain flavanol-rich foods, beverages, and supplements.     

Effects of Increasing Levels of Nickel Contamination on Structure of Offshore Nematode Communities in Experimental Microcosms

A microcosm experiment was used to examine the effects of nickel on offshore nematode communities of a Tunisian coastal zone (Southwestern Mediterranean Sea). Sediments were contaminated with three nickel concentrations [low (250 ppm), medium (550 ppm) and high (900 ppm)], and effects were examined after 30 days. Results showed significant differences between nematode assemblages from undisturbed controls and those from nickel treatments. Most univariates measures, including diversity and species richness, decreased significantly with increasing level of Ni contamination. Results from multivariate analyses of the species abundance data demonstrated that responses of nematode species to the nickel treatments were varied: Leptonemella aphanothecae was eliminated at all the nickel doses tested and seemed to be intolerant species to nickel contamination; Daptonema normandicum, Neochromadora trichophora and Odontophora armata which significantly increased at 550 ppm nickel concentration appeared to be “opportunistic” species at this dose whereas Oncholaimus campylocercoides and Bathylaimus capacosus which increased at all doses tested (250, 550 and 900 ppm) seemed to be “nickel-resistant” species.     

Applying a new bilateral mammographic density segmentation method to improve accuracy of breast cancer risk prediction

Purpose

How to optimally detect bilateral mammographic asymmetry and improve risk prediction accuracy remains a difficult and unsolved issue. Our aim was to find an effective mammographic density segmentation method to improve accuracy of breast cancer risk prediction.

Methods

A dataset including 168 negative mammography screening cases was used. We applied a mutual threshold to bilateral mammograms of left and right breasts to segment the dense breast regions. The mutual threshold was determined by the median grayscale value of all pixels in both left and right breast regions. For each case, we then computed three types of image features representing asymmetry, mean and the maximum of the image features, respectively. A two-stage classification scheme was developed to fuse the three types of features. The risk prediction performance was tested using a leave-one-case-out cross-validation method.

Results

By using the new density segmentation method, the computed area under the receiver operating characteristic curve was 0.830 ± 0.033 and overall prediction accuracy was 81.0%, significantly higher than those of 0.633 ± 0.043 and 57.1% achieved by using the previous density segmentation method (\(p<0.01\), t-test).

Conclusions

A new mammographic density segmentation method based on a bilateral mutual threshold can be used to more effectively detect bilateral mammographic density asymmetry and help significantly improve accuracy of near-term breast cancer risk prediction.

     

Effect of Continuous Glucose Monitoring Accuracy on Clinicians’ Retrospective Decision Making in Diabetes: A Pilot Study

Background:

The use of continuous glucose monitoring (CGM) in clinical decision making in diabetes could be limited by the inaccuracy of CGM data when compared to plasma glucose measurements. The aim of the present study is to investigate the impact of CGM numerical accuracy on the precision of diabetes treatment adjustments.

Method:

CGM profiles with maximum 5-day duration from 12 patients with type 1 diabetes treated with a basal-bolus insulin regimen were processed by 2 CGM algorithms, with the accuracy of algorithm 2 being higher than the accuracy of algorithm 1, using the median absolute relative difference (MARD) as the measure of accuracy. During 2 separate and similar occasions over a 1-month interval, 3 clinicians reviewed the processed CGM profiles, and adjusted the dose level of basal and prandial insulin. The precision of the dosage adjustments were defined in terms of the interclinician agreement and the intraclinician reproducibility of the decisions. The Cohen’s kappa coefficient was used to assess the precision of the decisions. The study was based on retrospective and blind CGM data.

Results:

For the interclinician agreement, in the first occasion, the kappa of algorithm 1 was .32, and that of algorithm 2 was .36. For the interclinician agreement, in the second occasion, the kappas of algorithms 1 and 2 were .17 and .22, respectively. For the intraclinician reproducibility of the decisions, the kappas of algorithm 1 were .35, .22, and .80 and the kappas of algorithm 2 were .44, .52, and .32, for the 3 clinicians, respectively. For the interclinician agreement, the relative kappa change from algorithm 1 to algorithm 2 was 86.06%, and for the intraclinician reproducibility, the relative kappa change from algorithm 1 to algorithm 2 was 53.99%.

Conclusions:

Results indicated that the accuracy of CGM algorithms might potentially affect the precision of the CGM-based insulin adjustments for type 1 diabetes patients. However, a larger study with several clinical centers, with higher number of clinicians and patients is required to validate the impact of CGM accuracy on decisions precision.     

Effects of Pentoxifylline on Non-Alcoholic Steatohepatitis: A Randomized,Double-Blind,Placebo-Controlled Trial in Iran

Background:

Non-alcoholic steatohepatitis (NASH) is a progressive form of nonalcoholic fatty liver disease. Several studies suggest that pentoxifylline (PTX) can improve the disease outcome.

Objectives:

We aimed to compare the effect of pentoxifylline with placebo on liver aminotransferases and cytokines, including interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α), and interleukin 8 (IL-8) in patients with NASH.

Patients and Methods:

Thirty patients with NASH were included in the study, based on ultrasonography and 1.5-fold mean change from baseline serum levels of liver aminotransferases. Patients with NASH were randomized to receive 1200 mg PTX (the intervention group) or placebo (the placebo group) for 6 months. The serum levels of liver aminotransferases and cytokines were compared between the intervention and placebo groups, at various time points.

Results:

The serum levels of liver aminotransferases were significantly reduced at 3 months and at 6 months, compared with baseline, in both groups. The serum levels of IL-6 were significantly decreased, in both groups, only at 6 months, compared with baseline. Compared to the placebo group, the serum level of TNF-α was significantly decreased in the intervention group, at 6 months. The serum level of IL-8 was increased, in both groups, after 6 months, without reaching clinical significance. There was no significant difference in serum levels of liver aminotransferases and cytokines, between intervention and placebo groups.

Conclusions:

Decreases in the serum levels of liver aminotransferases and cytokines, in both groups, are related to low-calorie diets and exercise, rather than PTX.     

Epigenetic involvement in etiopathogenesis and implications in treatment of systemic lupus erythematous

Background

Recent researches in the field of genetics have extended our knowledge through the discovery of genetic factors associated with autoimmune diseases (AID). Genetics by itself, however, cannot elucidate all the uncertainties encountered in the etiopathology of AID. On the other hand, incomplete harmony in the prevalence of AID in identical twins suggests that non-genetic factors may play an important role in determining the disease susceptibility. Besides, epigenetics, which is defined by changes in gene expression without a corresponding change in the DNA sequences, has come in to provide new awareness in the disease etiopathology by bridging the genetic and epigenetic factors. The recent advances in the field of epigenetics provide a new insight into the understanding of the disease mechanisms, development, diagnostic and prognostic approaches, as well as the various treatment methods.

Purpose

This review paper aims to present an overview of epigenetic modifications involved in the pathogenesis of systemic lupus erythematosus (SLE) and discuss their important roles in clinical and pharmacological settings, including novel and recent therapeutic applications.

Results

Nowadays, it is believed that autoimmune diseases, such as SLE, begin when genetically susceptible factors associate with environmental triggers. The current therapeutic approaches for SLE treatment have been based on treatments with immunosuppressive drugs, which are linked to various side effects. It is difficult to develop highly effective treatments for SLE patients with minimal or no side effects, mainly due to the disease complexity. The breakthrough of pharmacoepigenetics provides a new approach to solve this problem. Epigenetic modifications can influence the efficacy of drugs by changing the gene expression through modifying chromatin remodeling. In this regard, epigenetic studies in SLE are expected to reveal novel disease biomarkers and therapeutic targets.

Conclusions

Accumulating evidence disclosed that epigenetic dysregulations are engaged in SLE pathogenesis and may be exerted as biomarkers to diagnose and as tools to treat these patients.

     

The Association Between Gastric Endoscopic Findings and Histologic Premalignant Lesions in the Iranian Rural Population

Atrophic gastritis, intestinal metaplasia, and gastric dysplasia are histologic premalignant lesions (PMLs). Correlation between the gastric endoscopic findings and histologic PMLs is not clear. This study was designed to determine the possible association of endoscopic findings and histologic PMLs.Over 28 months gastric endoscopic findings of consecutive rural patients with dyspepsia were categorized into 3 groups: 1—normal, 2—ulcerative with or without concurrent abnormality, 3—abnormal non-ulcerative. Biopsies of antrum and body were taken from all included patients and examined for the presence of histologic PMLs. Any mucosal abnormality was also biopsied.From 7340 evaluated patients, an overall of 1973 patients were included. 55.7% of patients were in group 1; 3.8% in group 2 and 40.5% in group 3. A within sex analysis showed that the majority of male patients were in PMLs subgroup (P < 0.001) likewise in groups 2 and 3 (P < 0.001). The prevalence of histologic PMLs in groups 2 and 3 was significantly higher than group 1 (P < 0:001) but the difference was not significant between groups 2 and 3 (P = 0.484). Mean (±SD) age of patient with PMLs was 50.25 ± 17.71 whereas in patients without PMLs was 41.16 ± 16.48 (P < 0.001).This study has showed that abnormal gastric endoscopic findings, male sex and increased age can be considered as risk factors of the formation of histologic PMLs. Until further investigations we propose that any abnormality on gastric mucosa (ulcerative or non-ulcerative) could be biopsied for the evaluation of probable histologic PMLs especially in old men.     

Nursing home admission in elderly subjects with dementia: predictive factors and future challenges

ObjectivesThe aim of this study was to identify factors predictive of nursing home admission (NHA) over a period of 1 year among elderly subjects with dementia.MethodsThe study population was drawn from the SAFES cohort that was formed within a national research program into the recruitment of emergency departments in 9 teaching hospitals. Subjects were to have been hospitalized in a medical ward in the same hospital as the emergency department to which they were initially admitted. Subjects who experienced NHA before emergency department admission were excluded. Those with a confirmed diagnosis of dementia were considered in the present analysis. NHA has been defined as the incident admission into either a nursing home or other long term care facility within the follow-up period. Data obtained from a Comprehensive Geriatric Assessment were used in a Cox model to predict 1-year NHA.ResultsThe 425 subjects of the study were 86 ± 6 years old, and were mainly women (63%). NHA rate was 40% (n = 172). Four factors were identified to increase NHA risk: age 85 or older (hazard ratio [HR] = 1.5; 95% confidence interval [CI] = 1.1–2.1), inability to use the toilet (HR = 2.5; 95% CI = 1.5–4.2), balance disorders (HR = 1.5; 95% CI = 1.1–2.1), and living alone (HR = 1.5; 95% CI = 1.1–2.1). Three factors decreased this risk significantly: inability to transfer (HR = 0.5; 95% CI = 0.3–0.8), increased number of children (HR = 0.88; 95% CI = 0.96–0.99), and increased initial Mini-Mental State Examination score (HR = 0.97; 95% CI = 0.8–0.9).ConclusionNHA determinants in dementia are strongly linked to the patient’s own characteristics but also to his or her physical or social environment. Interventions should target both members of the dyad “patient-caregiver” because both are affected by the disease.     

Pediatric Hydatidosis in Iranian Referral Pediatrics Center

Background

Hydatidosis is one of the major zoonotic diseases that cause considerable public health problems in Iran. The present study was designed to investigate pediatric hydatidosis in patients referred to the Children Medical Center Hospital in Tehran, Iran during 2005-2010.

Methods

Data were collected from the records of 17 patients referred to the center with hydatidosis. Data included demographic data; laboratory results, type, and site of cysts, clinical manifestations, and treatment.

Results

Nine patients were boys (52.9%) and eight (47.1%) were girls. Most patients referred from central areas of Iran (58.8%). Seven patients had cysts in their lungs (41.2%) and three cases (17.6%) in liver. Six cases (35.3%) had simultaneous lung and liver cysts, 3 patients (17.6%) had brain cysts (alone or in combination with other organs involvement) and 2 patients (11.7%) showed multi-organ involvement. All patients were treated by albendazole and underwent surgery, recurrence was seen in 4 (23.5%) of the cases and one patient died due to rupture of the cyst and anaphylactic shock.

Conclusion

Multi-organ involvement seems to be on the rise in children, this has led to the necessity for physicians to be more aware of clinical features, search, and rule out other organs for involvement diagnosis once a cyst is detected in one organ.