Psyllium improves dyslipidaemia,hyperglycaemia and hypertension,while guar gum reduces body weight more rapidly in patients affected by metabolic syndrome following an AHA Step 2 diet

The aim of this study was to comparatively evaluate the long-term effects of psyllium husk and guar gum supplementation on metabolic syndrome (MS) components. We randomised 141 MS patients to soluble psyllium husk powder or guar gum 3.5 g t.i.d. to be taken 20 min before the main 2 meals, or to a standard diet for a cumulative period of 6 months. Both fibres significantly improved body mass index (−7.2% vs. −6.5%), fasting plasma glucose (−27.9% vs. −11.1%) and insulin (−20.4% vs. −10.8%), HOMA Index (−39.2% vs. −16.7%), glycated haemoglobin (−10.4% vs. −10.3%), low-density lipoprotein cholesterol (−7.9% vs. −8.5%) and apolipoprotein B (−10.5% vs. −5.6%), after 6 months of treatment. Only the psyllium supplementation exerted a significant improvement on plasma triglyceride concentration (−13.3%) and systolic (−3.9%) and diastolic blood pressure (−2.6%). No significant difference was observed regarding the standard diet group in comparison to the baseline. On the basis of our data, psyllium could be more strongly indicated for patients that have to reduce a large number of cardiovascular risk factors, while guar gum could be more rapidly efficacious in strengthening the effect of diets aimed at reducing body weight.     

The gene expression profile of cumulus cells reveals altered pathways in patients with endometriosis

Purpose

The objective of this experimental study was to compare the global gene expression profile of CC of mature oocytes in 18 patients with severe endometriosis and CC in 18 control patients affected by a severe male factor.

Methods

For each group, the CC were pooled, RNA was extracted and a microarray performed. For validating the microarray, a quantitative real-time PCR was performed in the CC of an independent set of patients with endometriosis (n = 5) and controls (n = 7).

Results

595 differentially expressed genes (320 down-regulated, 275 up-regulated, p < 0.05, fold change ≥1.5) were identified. The most significant changes were observed in genes involved in the chemokine signaling and cell-cell or cell-extracellular matrix adhesion pathways. Several genes of these pathways were down-regulated in endometriosis. Individual RT-PCR assays confirmed the microarray for ten genes.

Conclusions

Several genes involved in the chemokine mediated-signaling pathway and in the functional cross-talk between CC and the oocyte are down-regulated in endometriosis CC. The impairment of these processes could explain the reduction of oocyte competence in endometriosis. This preliminary knowledge could be the starting point for a more detailed elucidation of the relationship between endometriosis and oocyte competence.

Electronic supplementary material

The online version of this article (doi:10.1007/s10815-014-0305-1) contains supplementary material, which is available to authorized users.     

Monocyte-mediated antibody-dependent cell-mediated cytotoxicity: the role of the metabolic burst

Human monocytes respond to opsonized microorganisms with a "metabolic burst" composed of an increase in oxygen consumption, an increase in hexose monophosphate shunt (HMPS) activity, and the generation of reactive oxygen species (ROS). We investigated the role of the metabolic burst in antibody-dependent cell-mediated cytotoxicity (ADCC) by human monocytes toward anti-D coated erythrocyte target cells because recent studies suggested a role for oxygen-dependent bactericidal mechanisms in ADCC. In normal monocytes, we found that ADCC was nearly halved under hypoxic conditions. Several agents known to impair activation of the burst, such as vincristine, cation chelators, and a sulfhydryl reagent, all decreased cytotoxicity if added before initiation of contact between target and effector cells. Cytotoxicity was inhibited by 2-deoxyglucose but not fluoride, suggesting a nonglycolytic role for glucose in ADCC, perhaps in the HMPS pathway. Although these data suggested a role for the metabolic burst in ADCC, scavengers of ROS did not impair cytotoxicity, and monocytes from chronic granulomatous disease (CGD) patients who had a defective metabolic burst had normal levels of ADCC. We conclude that ADCC toward anti-D coated erythrocyte target cells was the result of at least two independent but closely related cytotoxic pathways. Although one of these pathways appeared to involve the metabolic burst, the potentially cytotoxic reactive oxygen species did not appear to play a role in this system.     

Quality of Sexual Life of Women on Oral Contraceptive Continued‐Regimen: Pilot Study

IntroductionTo date, women may use flexible oral contraceptive (OC) regimens.AimThe aim of this study was to evaluate the quality of sexual life of healthy women on continued‐regimen OCs.MethodsFifty women (age range 18–38) were enrolled. The Female Sexual Function Index (FSFI) and the Short Form‐36 (SF‐36) questionnaires were used to investigate, respectively, sexual behavior and the quality of life (QoL) of women on OC for 72 days with a 4‐day hormone‐free interval, for two cycles. Both the FSFI and the SF‐36 were administered before starting OC intake, at the first (72–82 days) and the second (144–154 days) follow‐ups.Main Outcome MeasureThe main outcomes are the FSFI and the SF‐36 questionnaires.ResultsThe FSFI score obtained at the first follow‐up detected a worsening with respect to baseline score (P < 0.05). The score obtained at the second follow‐up detected an improvement with respect to both the baseline and the first follow‐up total scores (P < 0.05). QoL improved at the first follow‐up only as regards body pain (P < 0.05), and at the second follow‐up as regards: physical role, body pain, general health, vitality, and social function (P < 0.05).ConclusionsoThe use of continued‐regimen OCs is able to improve the sexual behavior and the QoL of women. Caruso S, Malandrino C, Cicero C, Ciancio F, Cariola M, and Cianci A. Quality of sexual life of women on oral contraceptive continued‐regimen: Pilot study. J Sex Med 2013;10:460-466.     

Role of multislice computed tomography in the diagnosis of gene-mutation-associated pancreatitis (GMAP)

Purpose

The aim of this study was to review the computed tomography (CT) features of the pancreatic parenchyma and ducts in patients with gene-mutation-associated pancreatitis (GMAP).

Materials and methods

Twenty-five patients with GMAP were included in this retrospective study. Patients were divided into two groups according to the time interval between the onset of symptoms and the first CT examination (group A ≤24 months and group B >25 months).

Results

On qualitative image assessment, in group A patients, pancreatic duct stones were detected in 2/13 with GMAP. All stones were calcified and homogenous. Enhancement of the pancreatic parenchyma was hypovascular in 7/13 patients. In group B patients, pancreatic duct stones were detected in 12/12 with GMAP. Stones were calcified in 10/12 cases and noncalcified (protein plugs) in 2/12; in 5/10 cases, the calcified stones were heterogeneous with noncalcified central core (bull’s-eye appearance). Enhancement of the pancreatic parenchyma was hypovascular in 12/12 patients. On quantitative image assessment, in group A patients, the mean diameter of duct stones was 0.6 mm (range 0–5 mm). Mean diameter of the main duct in the pancreatic head and body/tail was 4.8 mm and 4.9 mm, respectively. In group B patients, the mean diameter of duct stones was 21.9 mm (range 2–50 mm). Mean diameter of the main duct in the pancreatic head and body/tail was 18.8 mm and 13.9 mm, respectively.

Conclusions|

In patients with GMAP and time interval between symptom onset and first CT scan ≤24 months (group A), CT identified normal or slightly increased parenchymal thickness and a main pancreatic duct of normal calibre and without duct stones. In contrast, in patients with GMAP and time interval between symptom onset and first CT scan >25 months (group B), it identified large-calibre duct stones with bull’s-eye appearance.     

Common bile duct calculi: updated experience with dissolution with methyl tertiary butyl ether

The authors describe their experience with methyl tertiary butyl ether (MTBE) in a larger series of patients than previously reported in order to acquaint physicians with both its effectiveness for dissolution of common bile duct calculi and the limitations of its use. Ten patients with 13 biliary calculi underwent percutaneous stone dissolution treatment with the experimental cholesterol solvent, MTBE. Three stones completely dissolved within 30 minutes, seven were reduced in size, and three were visibly unaffected. All stones not completely dissolved were easily extracted by means of a stone basket except for one in a patient taken to surgery. Although MTBE perfusion is an effective technique for management of biliary calculi, practitioners should be aware that its use is quite time consuming and its odor difficult to control.     

Effects of Odanacatib on Bone Structure and Quality in Postmenopausal Women With Osteoporosis: 5-Year Data From the Phase 3 Long-Term Odanacatib Fracture Trial (LOFT) and its Extension

Odanacatib (ODN), a selective oral inhibitor of cathepsin K, was an investigational agent previously in development for the treatment of osteoporosis. In this analysis, the effects of ODN on bone remodeling/modeling and structure were examined in the randomized, double-blind, placebo-controlled, event-driven, Phase 3, Long-term Odanacatib Fracture Trial (LOFT; NCT00529373) and planned double-blind extension in postmenopausal women with osteoporosis. A total of 386 transilial bone biopsies, obtained from consenting patients at baseline (ODN n = 17, placebo n = 23), month 24 (ODN n = 112, placebo n = 104), month 36 (ODN n = 42, placebo n = 41), and month 60 (ODN n = 27, placebo n = 20) were assessed by dynamic and static bone histomorphometry. Patient characteristics at baseline and BMD changes over 5 years for this subset were comparable to the overall LOFT population. Qualitative assessment of biopsies revealed no abnormalities. Consistent with the mechanism of ODN, osteoclast number was higher with ODN versus placebo over time. Regarding bone remodeling, dynamic bone formation indices in trabecular, intracortical, and endocortical surfaces were generally similar in ODN-treated versus placebo-treated patients after 2 years of treatment. Regarding periosteal modeling, the proportion of patients with periosteal double labels and the bone formation indices increased over time in the ODN-treated patients compared with placebo. This finding supported the observed numerical increase in cortical thickness at month 60 versus placebo. In conclusion, ODN treatment for 5 years did not reduce bone remodeling and increased the proportion of patients with periosteal bone formation. These results are consistent with the mechanism of action of ODN, and are associated with continued BMD increases and reduced risk of fractures compared with placebo in the LOFT Phase 3 fracture trial. © 2020 American Society for Bone and Mineral Research.     

Vitamin K status in cystic fibrosis

Appearance of PIVKA-II (protein induced by vitamin K absence-II) in serum is a biochemical sign of insufficient vitamin K-dependent carboxylation of prothrombin. Plasma concentrations of PIVKA-II and vitamin K1 were determined in 24 children with cystic fibrosis. Eight were supplemented with vitamin K1. The purpose of the study was to determine the occurrence of vitamin K deficiency in cystic fibrosis and to evaluate the effect of vitamin K supplementation. PIVKA-II was detectable in only one unsupplemented child. In this patient, the concentration of vitamin K1 was below the limit of detection of 60 ng/l. Vitamin K1 levels in the other unsupplemented children were normal (mean 476 ng/l = 1 mmol/l). The supplemented patients showed extremely high levels of vitamin K1 (mean 22445 ng/l = 50 nmol/l). In conclusion, vitamin K deficiency occurs infrequently in cystic fibrosis. Checking the coagulation system is advised, but routine vitamin K supplementation is not recommended. If additional vitamin K is needed, the starting dose should not exceed 1 mg daily.