A Short Study Exploring the Effect of the Glycaemic Index of the Diet on Energy intake and Salivary Steroid Hormones

From PubMed via Jisc Publications RouterThe glycaemic index or load (GI or GL) is a concept for ranking carbohydrate-rich foods based on the postprandial blood glucose response compared with a reference food (glucose). Due to the limited research investigating the effect of the GI or GL of the diet on salivary steroidal hormones, this explorative short study was conducted. 12 female participants consumed a low GI and a high GI diet for three days each, followed by a washout period between each intervention. Saliva was collected at baseline, and following the low or high GI diets. Cortisol and testosterone concentrations were measured by enzyme-linked immuno-sorbent assay (ELISA). GI and GL were significantly different between the low and high GI diets ( < 0.001). There was a small but significant increase in salivary cortisol after the high GI diet (7.38 to 10.93 ng/mL, = 0.036). No effect was observed after the low GI diet. Higher levels of testosterone were produced after the low GI diet (83.7 to 125.9 pg/mL, = 0.002), and no effect was found after the high GI diet. The total intake of calories consumed on the low GI diet was significantly lower compared to the high GI diet ( = 0.019). A low GI diet was associated with a small but significant increase in salivary testosterone, while a high GI diet increased cortisol levels. Altering the GI of the diet may influence overall energy intake and the health and wellbeing of female volunteers.11pubpub

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Effect of Glycaemic index of the diet on salivary cortisol and testosterone levels in females

There has been great interest in the effect of Glycaemic index (GI) of food on weight reduction, obesity, metabolic syndrome and general well being in women. The majority of research into GI was focussed towards improving blood glucose control in diabetes. Also, favourable changes in blood lipids and some beneficial effect in cancers have been reported. The aim of this pilot study is to investigate the impact of ingesting food with varying GI on salivary cortisol and testosterone levels. A cross-over design was adopted and 8 healthy female subjects volunteered for the study (20-23 years old). The project has received ethical approval by QMUC ethical committee. A diet is said to be of low GI if it has a GI of less than 55, medium GI if it has a GI of 56-69, and a high GI if it is 70 or greater. All subjects consumed a low GI or high GI diet for three days each, with a washout period separating the two. Saliva samples at baseline, after the low GI diet, washout period and high GI diet were collected at 4 different times during the day. Salivary cortisol and testosterone concentrations were measured by ELISA methods. GI was significantly different between the low and high GI diets. No significant difference in cortisol concentration was found on either diet. Significantly more testosterone was produced on the low GI diet compared to basal values (related t-test P=0.05) (see Table below). It was found that lower calories were consumed on the low GI diet compared to the high GI diet and the subject's normal diet was very similar to the high GI diet. Steroid Basal Low GI Washout High GI Unit Cortisol 8.834 11.18 9.54 9.19 ng/mL Testosterone 83.71 123.2 111.14 101.15 pg/mL In conclusion, it appears that GI of the diet consumed by females influences a variety of parameters and that a low GI diet might increase salivary testosterone concentrations. --------------------------------------------------------------------------------sch_diepub790pu

Assessing local building cultures for resilience & development: A practical guide for community-based assessment

International audienceThe development of a set of tools to enhance appreciation of local practices developed by communities regarding settlements and risks is an initiative that aims to promote context-based strategies for responding efficiently and adequately to habitat improvement and vulnerability reduction needs. This guide offers a methodological and operational support for decision-making and practices towards approaches and actions deeply rooted in local contexts. It is a practical tool that provides detailed explanation on planning, preparing and undertaking field assessments of local practices related to habitat and risks. It refers to a participatory approach suitable for, and adapted to, various geographical, cultural and risk-prone areas. By supporting habitat assessment in all its different aspects, it also fosters links between programmes, providing clues and keys to define and implement coherent projects including income generating activities, livelihood, health and other related sectors. The necessary investment to be taken into account in project planning to achieve the basic step described in this booklet will result in huge savings, as logistical issues will be drastically reduced during the project implementation. It is a worthwhile investment that will lead to decisions ensuring more benefits to the affected communities, including a long-term enhancement of their resilience capacityCet ouvrage s'adresse aux responsables de projets et aux preneurs de décisions. L'auteur explique tout d'abord la démarche de projet respectueuse des cultures constructives. L'auteur présente ensuite une méthode d'évaluation des cultures constructives locales et expose l'importance de celle-ci dans un proje

Stoma-free survival after anastomotic leak following rectal cancer resection: worldwide cohort of 2470 patients

Background: The optimal treatment of anastomotic leak after rectal cancer resection is unclear. This worldwide cohort study aimed to provide an overview of four treatment strategies applied. Methods: Patients from 216 centres and 45 countries with anastomotic leak after rectal cancer resection between 2014 and 2018 were included. Treatment was categorized as salvage surgery, faecal diversion with passive or active (vacuum) drainage, and no primary/secondary faecal diversion. The primary outcome was 1-year stoma-free survival. In addition, passive and active drainage were compared using propensity score matching (2: 1). Results: Of 2470 evaluable patients, 388 (16.0 per cent) underwent salvage surgery, 1524 (62.0 per cent) passive drainage, 278 (11.0 per cent) active drainage, and 280 (11.0 per cent) had no faecal diversion. One-year stoma-free survival rates were 13.7, 48.3, 48.2, and 65.4 per cent respectively. Propensity score matching resulted in 556 patients with passive and 278 with active drainage. There was no statistically significant difference between these groups in 1-year stoma-free survival (OR 0.95, 95 per cent c.i. 0.66 to 1.33), with a risk difference of -1.1 (95 per cent c.i. -9.0 to 7.0) per cent. After active drainage, more patients required secondary salvage surgery (OR 2.32, 1.49 to 3.59), prolonged hospital admission (an additional 6 (95 per cent c.i. 2 to 10) days), and ICU admission (OR 1.41, 1.02 to 1.94). Mean duration of leak healing did not differ significantly (an additional 12 (-28 to 52) days). Conclusion: Primary salvage surgery or omission of faecal diversion likely correspond to the most severe and least severe leaks respectively. In patients with diverted leaks, stoma-free survival did not differ statistically between passive and active drainage, although the increased risk of secondary salvage surgery and ICU admission suggests residual confounding