Is arterial stiffness in HIV-infected individuals associated with HIV-related factors?

We investigated the association between pulse wave velocity (PWV) and HIV infection, antiretroviral treatment-related characteristics, viral load, immune status, and metabolic changes in a cross-sectional study nested in a cohort of HIV/AIDS patients who have been followed for metabolic and cardiovascular changes since 2007. The study included patients recruited from the cohort (N = 261) and a comparison group (N = 82) of uninfected individuals, all enrolled from April to November 2009. Aortic stiffness was estimated using the carotid-femoral PWV (Complior-Artech, Paris, France). The groups were similar with respect to age, metabolic syndrome, diabetes mellitus, Framingham score, and use of antihypertensive and hypolipidemic medications. Hypertension was more frequent among the controls. Individuals with HIV had higher triglyceride, glucose and HDL cholesterol levels. Among individuals with HIV/AIDS, those with a nadir CD4⁺ T-cell count <200 cells/mm³ had a higher PWV (P = 0.01). There was no statistically significant difference when subjects were stratified by gender. Heart rate, age, male gender, and blood pressure were independently correlated with PWV. Nadir CD4⁺ T-cell count did not remain in the final model. There was no significance difference in PWV between HIV-infected individuals and uninfected controls. PWV was correlated with age, gender, and blood pressure across the entire population and among those infected with HIV. We recommend cohort studies to further explore the association between inflammation related to HIV infection and/or immune reconstitution and antiretroviral use and PWV.     

p53抑制剂pifithrin-α对肝原代细胞增殖的影响

目的:观察p53抑制剂pifithrin-α对肝原代细胞增殖及增殖相关蛋白表达的影响。方法:肝原代细胞分别经0、10、20和30μmol/L的pifithrin-α处理1h后,再用10nmol/LEGF诱导30、36和48h,用放射性计数法测定细胞增殖水平。另取肝原代细胞,分3组,对照组常规培养,EGF组用10nmol/L的EGF诱导,EGF+pifithrin-α组用30μmol/Lpifithrin-α和10nmol/LEGF诱导,EGF诱导24、30h后,Westernblot法检测细胞中P53、P21、CyclinD、CyclinE、pErk蛋白的表达水平。结果:pifithrin-α作用后,EGF诱导的细胞增殖水平均降低,且pifithrin-α浓度越大,增殖水平越低(F剂量=54.690,F时间=214.370,F交互=50.450,P<0.001)。与对照组比较,EGF组细胞P53、Cyc-linE蛋白表达水平未发生变化,但P21、CyclinD及pErk表达水平升高(P<0.05),EGF+pifithrin-α组细胞P21、CyclinD及pErk蛋白表达水平较EGF组降低(P<0.05)。结论:P53蛋白可能通过激活MAPK信号通路、上调Cy-clinD表达,从而发挥促进肝原代细胞增殖的作用。     

National emission ceilings in Portugal—trends,compliance and projections

The national emission ceilings (NEC) Directive was implemented to contribute to the reduction of transboundary air pollutions impacts, limiting emissions of acidifying and eutrophication pollutants as well as ozone precursors. It was first adopted by the European Commission (EC) in 2001 (Directive 2001/81/EC) covering four pollutants (NO_x, SO₂, NH₃ and NMVOC). Under the scope of the clean air programme for Europe, which established the air policy objectives for 2020 and 2030, a new NEC was adopted (Directive 2016/2284/EU) establishing more strict ceilings for those pollutants and adding as well PM_2.5. The objective of this paper is to analyse the evolution of the Portuguese national emissions and the compliance of NEC Directive in 2010 and to foresee if the new ceilings for 2030 will be fulfilled. The emission inventories reported to the EC show that emissions in Portugal presented a consistent decreasing trend for all pollutants from 2000 to 2014, and a slight increase in 2015. The 2010 targets were achieved with measures implemented at the time (particularly on the energy, industrial combustion and transport sectors) which allowed Portugal to even surpass the defined goals. The emission projections for 2030, however, reveal that necessary emission reductions for all pollutants could be attained only if measures of the most demanding scenarios are implemented. Therefore, an integrated strategy should be designed and implemented aiming to not only fulfil the NEC in 2030 but also guarantee a better air quality with the highest cost-benefit for the environment and health.     

Low fecal calprotectin predicts clinical remission in Crohn's disease patients: the simple answer to a challenging question

Background and aim: Fecal calprotectin (FC) is a noninvasive marker of intestinal inflammation. Predicting relapses in Crohn’s disease (CD) patients can allow earlier changes in therapy. The aim of this study was to evaluate the role of FC in predicting relapse in CD patients in clinical remission within six months follow-up.

Methods: Patients with CD who were in clinical remission at least ≥3 months were included in this study. The first FC sample during the remission period was evaluated and was used as the baseline value. Relapse was defined as an unexpected escalation in therapy, hospitalization or need for surgery for active CD. The accuracy and optimal cutoff FC values for predicting clinical relapse at six months were assessed by the area under the ROC curve (AUC).

Results: One hundred and forty-four patients were evaluated, with mean age of 38.4 years. Of these, 13 (9%) had a relapse during the follow-up period. The mean FC value was significantly lower for non-relapsers (203.2?μg/g) than for relapsers (871.3?μg/g), p?<?.001. The AUC for predicting relapse by using FC values was 0.924. The optimal cutoff FC value to predict relapse was 327?μg/g; with values of sensitivity, specificity, negative predictive value and positive predictive value were 92.3%, 82.4%, 99.1% and 34.3%, respectively.

Conclusions: FC is more useful in predicting remission maintenance than relapse in patients with CD in clinical remission. Values of FC ≤327?μg/g can exclude relapse at least at six months follow-up period.     

Is there an association between overweight/obesity and dental implant complications? A systematic review and meta-analysis

The aim of this systematic review was to test the following hypotheses: (1) that there is no difference in implant survival rate between individuals with overweight or obesity and those who are within the ideal weight range; (2) that there are no differences between these groups regarding indicators of peri-implant health. Two independent reviewers performed a literature search of the PubMed/MEDLINE, Scopus, and Cochrane Library databases for studies published up to April 1, 2018. A meta-analysis was performed to determine the risk difference for implant failure and mean difference for marginal bone loss, probing depth, and bleeding on probing. Six studies were selected for review, involving a total of 746 patients with 986 implants: 609 in overweight or obese individuals and 377 in individuals within the ideal weight range. The findings of this systematic review indicate that the first hypothesis should be accepted, since no statistically significant difference in implant survival rate was found between individuals with overweight/obesity and those within the ideal weight range (P = 0.64). The second hypothesis was rejected, as the review indicated a difference in marginal bone loss (P < 0.00001), probing depth (P < 0.00001), and bleeding around dental implants (P < 0.00001).     

Objectively measured daily-life physical activity of moderate-to-severe Brazilian asthmatic women in comparison to healthy controls: A cross-sectional study

Considering the complex relationship between asthma symptoms and exercise, asthmatics are usually believed to be less active in daily life than healthy subjects. However, few studies have objectively assessed daily-life physical activity (DLPA) of asthmatic adults. Objective: To objectively assess DLPA of a sample of Brazilian asthmatic women in comparison to healthy controls, and to investigate the associations between DLPA and asthma control, health-related quality of life, anxiety and depression levels, and the Six-minute walk test (6MWT) in this population. Methods: Sixty-six women were included, 36 in the asthma group (AG) and 30 in the control group (CG). The AG was composed by clinically stable moderate-to-severe asthmatics. The CG was composed by apparently healthy volunteers. All subjects underwent DLPA assessment (considered as the average of steps taken during six consecutive days measured by a pedometer) and performed the 6MWT. Additionally, participants in the AG were assessed using the Asthma Control Questionnaire, the Asthma Quality of Life Questionnaire (AQLQ), and the Hospital Anxiety and Depression Scale. Results: There was no difference between the AG and the CG regarding DLPA (7490.3 ± 3330.2 vs 6876.4 ± 3242.1 steps respectively, p = 0.45), even after adjustment for covariates. DLPA was significantly correlated to the activity limitation domain of the AQLQ among asthmatics (r = 0.43, p < 0.01). Conclusion: Despite the association between self-perceived activity limitation and DLPA among asthmatics, there were no differences regarding DLPA between a sample of moderate-to-severe Brazilian asthmatic women and apparently healthy controls.