Iron Status is Associated with Mood,Cognition, and Functional Ability in Older Adults: A Cross-Sectional Study

Several conditions are risk factors for iron deficiency (ID), some of which are highly prevalent in older individuals. Despite the amount of evidence pointing for a role of ID in cognition, mood and physical functional ability, the research addressing these associations in older individuals is still scarce. In the present study, 162 older community-dwelling individuals (29.53% classified as ID) were enrolled in a cross-sectional analysis and characterized regarding cognition, mood, functional ability, general nutritional intake and iron status. Assessment of iron status was performed using several blood biomarkers. Storage and erythropoiesis dimensions were positively associated with memory, along with an interaction (moderator effect) between iron storage and nutritional status. A more depressed mood was negatively associated with (iron) transport, transport saturation and erythropoiesis dimensions, and functional tiredness was positively associated with the erythropoiesis dimension. These observations indicate that lower iron status is associated with depressive mood, functional tiredness and poorer memory ability, with the latter moderated by nutritional status. These findings suggest that using iron as a continuous variable may be useful in finding associations with iron homeostasis, eventually missed when iron levels are considered within the usual classification groups.     

Beeinflussung der psychosozialen Entwicklung von Kindern und Jugendlichen durch das Tragen von Gesichtsmasken im öffentlichen Raum zur Prävention von Infektionskrankheiten: Ein systematischer Review

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Zur Prävention tröpfchenübertragener Infektionskrankheiten wird das Tragen einer Maske im öffentlichen Raum...     

The Health Effects of Vitamin D and Probiotic Co-Supplementation: A Systematic Review of Randomized Controlled Trials

Evidence of synergic health effects of co-supplementation with vitamin D and probiotics is emerging. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA statement, scientific databases and the grey literature were searched, and a narrative review and risk of bias assessment were conducted. Seven randomized controlled trials were included, which had low risk of bias. Six studies were double-blind, and once single-blind, extended over 6–12 weeks, and included 50–105 participants. Conditions explored included schizophrenia, gestational diabetes, type 2 diabetes and coronary heart disease, polycystic ovarian syndrome, osteopenia, irritable bowel syndrome (IBS), and infantile colic. Supplementation frequency was daily or bi-monthly, with mainly vitamin D3, and Lactobacillus, Bifidobacterium, and Streptococcus. Comparators were placebo, vitamin D, lower vitamin D dose, and probiotics and lower vitamin D dose. The co-supplementation yielded greater health benefits than its comparators did in all studies except in one assessing IBS. Beneficial effects included decreased disease severity, improved mental health, metabolic parameters, mainly insulin sensitivity, dyslipidemia, inflammation, and antioxidative capacity, and lower use of healthcare. Co-supplementation of vitamin D and probiotics generated greater health benefits than its comparators did. More studies in other diseases and various populations are needed to confirm these findings and to elucidate the optimal form, composition, and frequency of this co-supplementation.     

Comparison of hybrid <Superscript>68</Superscript>Ga-PSMA-PET/CT and <Superscript>99m</Superscript>Tc-DPD-SPECT/CT for the detection of bone metastases in prostate cancer patients: <Emphasis Type="Italic">Additional value of morphologic information from low dose CT</Emphasis>

Purpose

This study compared ⁶⁸Gallium-prostate-specific-membrane-antigen based Positron-emission-tomography (⁶⁸Ga-PSMA-PET) and ^99metastabletechnetium-3,3-diphospho-1,2-propanedicarbonacid (^99mTc-DPD-SPECT) in performing skeletal staging in prostate cancer (PC) patients and evaluated the additional value of the information from low-dose-computed tomography (CT).

Materials and Methods

In this retrospective study, 54 patients who received ⁶⁸Ga-PSMA-PET/CT and ^99mTc-DPD-SPECT/CT within 80 days were extracted from our database. Osseous lesions were classified as benign, malignant or equivocal. Lesion, region and patient based analysis was performed with and without CT fusion. The reference standard was generated by defining a best valuable comparator (BVC) containing information from all available data.

Results

In the patient based analysis, accuracies measured as “area-under-the-curve” (AUC) for ⁶⁸Ga-PSMA-PET, ^99mTc-SPECT, ⁶⁸Ga-PSMA-PET/CT and ^99mTc-SPECT/CT were 0.97-0.96, 0.86-0.83, 1.00 and 0.83, respectively (p<0.05) (ranges = optimistic vs. pessimistic view). Region based analysis resulted in the following sensitivities and specificities: 91.8-97.7%, 100-99.5% (PET); 61.2-70.6%, 99.8-98.3% (SPECT); 97.7%, 100% (PET/CT), 69.4% and 98.3% (SPECT/CT) (p<0.05). The amount of correct classifications of equivocal lesions by CT was significantly higher in PET (100%) compared to SPECT (52.4%) (p<0.05).

Conclusion

⁶⁸Ga-PSMA-PET outperforms ^99mTc-DPD-SPECT in detecting bone metastases in PC patients. Additional information from low-dose-CT resulted in a significant reduction in equivocal lesions in both modalities, however ⁶⁸Ga-PSMA-PET benefited most.

Key Points

? Ga-PSMA-PET outperforms ^99m Tc-DPD-SPECT in skeletal staging in prostate cancer patients ? Proportion of equivocal decisions was significantly reduced by CT-fusion in both modalities ? Ga-PSMA-PET benefits more from CT information, compared to ^99m Tc-DPD-SPECT

     

Targeting glucose transport and the NAD pathway in tumor cells with STF-31: a re-evaluation

Background

Targeting glucose metabolism is a promising way to interfere with tumor cell proliferation and survival. However, controversy exists about the specificity of some glucose metabolism targeting anticancer drugs. Especially the potency of STF-31 has been debated. Here, we aimed to assess the impact of the glucose transporter (GLUT) inhibitors fasentin and WZB117, and the nicotinamide phosphoribosyltransferase (NAMPT) inhibitors GMX1778 and STF-31 on tumor cell proliferation and survival, as well as on glucose uptake.

Methods

Tumor-derived A172 (glioblastoma), BHY (oral squamous cell carcinoma), HeLa (cervix adenocarcinoma), HN (head neck cancer), HT-29 (colon carcinoma) and MG-63 (osteosarcoma) cells were treated with fasentin, WZB117, GMX1778 and STF-31. Proliferation rates and cell viabilities were assessed using XTT, crystal violet and LDH assays. mRNA and protein expression of GLUT1 and NAPRT were assessed using qPCR and Western blotting, respectively. The effects of inhibiting compounds on glucose uptake were measured using [¹⁸F]-fluoro-deoxyglucose uptake experiments.

Results

Stimulation of tumor-derived cells with the different inhibitors tested revealed a complex pattern, whereby proliferation inhibiting and survival reducing concentrations varied in [¹⁸F]-fluoro-deoxyglucose uptake experiments more than one order of magnitude among the different cells tested. We found that the effects of GMX1778 and STF-31 could be partially abolished by (i) nicotinic acid (NA) only in nicotinic acid phosphoribosyltransferase (NAPRT) expressing cells and (ii) nicotinamide mononucleotide (NMN) in all cells tested, supporting the classification of these compounds as NAMPT inhibitors. In short-time [¹⁸F]-fluoro-deoxyglucose uptake experiments the application of WZB-117 was found to lead to an almost complete uptake inhibition in all cells tested, whereas the effect of fasentin was found to be cell type dependent with a maximum value of ~35% in A172, BHY, HeLa and HT-29 cells. We also found that STF-31 inhibited glucose uptake in all cells tested in a range of 25–50%. These data support the classification of STF-31 as a GLUT inhibitor.

Conclusions

Our data reveal a dual mode of action of STF-31, serving either as a NAMPT or as a GLUT inhibitor, whereby the latter seems to be apparent only at higher STF-31 concentrations. The molecular basis of such a dual function and its appearance in compounds previously designated as NAMPT-specific inhibitors requires further investigation.

     

Another fatal case related to the recreational abuse of U-47700

The abuse of synthetic opioids has become a major threat in recent years. Several clinical reports and fatal case reports exist discussing life-threatening hypoventilation and fatal respiratory depression following the abuse of trans-3,4-dichloro-N-(2-(dimethylamino)cyclohexyl)-N-methylbenzamide (U-47700). The reported concentration of U-47700 in peripheral blood varies between 0.01 μg/mL and 1.46 μg/mL. These values depend on the mode of administration and whether the drug was used in combination with other drugs and/or pharmaceuticals. In the past, U-47700 was predominantly insufflated and not injected. The current study presents a non-targeted liquid chromatography/mass spectrometry (LC/MS)-based screening approach of urine and cerebrospinal fluid samples after intravenous injection of U-47700. Furthermore, quantitative values on U-47700 as obtained by liquid chromatography coupled to a linear ion trap (LC/ESI-QTRAPMS) are presented concerning femoral blood (0.29 μg/mL), urine (0.24 μg/mL), gastric contents (0.57 μg/mL), bile fluid (2.3 μg/mL), heart blood (1.25 μg/mL), liver (9.9 μg/g), cerebrospinal fluid (0.4 μg/mL), and hair (0.14 ng/mg). Thereof, concentrations in hair, gastric contents, bile fluid and cerebrospinal fluid have never been reported before. Drug paraphernalia were also analyzed by liquid chromatography coupled to a diode array detector (LC/DAD) and nuclear magnetic resonance spectrometer (NMR). The analyses show that the powder had a relatively high purity and was adulterated to a low degree. This is the first case report which lists concentration distributions of various specimens after intravenous injection. These findings as well as the U-47700 concentration are important to evaluate autopsy cases of U-47700 intoxication in the future.     

Tumor cell implantation after colonoscopy with biopsies in a patient with rectal cancer

PURPOSE: Colonoscopy with biopsy(ies) is performed in patients with colorectal cancer for diagnosis and screening of synchronous lesions. There is some fear of spreading the disease related to implantation of tumor cells at sites of mucosal damage or to hematogenous or lymphatic spread as a result of tumor manipulation. METHODS: A total colonoscopy including biopsies, performed in a patient because of anal blood loss and tenesmus, revealed a circular, polypoid, ulcerated mass from 1.5 to 12 cm above the anal verge. After preoperative radiotherapy, the patient was subjected to surgical intervention. RESULTS: Histopathology revealed a poorly differentiated rectum adenocarcinoma, staged pT4N1Mx. At approximately 12 cm proximally from the tumor, a biopsy taken through a minute irregularity of the mucosa revealed some granulation tissue with adjacent normal colon mucosa. The basis of this granulation tissue, corresponding to submucosa, contained poorly differentiated tumor elements. CONCLUSIONS: This tiny lesion might have been caused by implantation of exfoliated cancer cells in a biopsy site. It may not be without risk to create excessive biopsy lesions in the presence of a manifestly malignant tumor because of the possibility of tumor cell implantation.