Acute cocoa flavanol supplementation improves muscle macro- and microvascular but not anabolic responses to amino acids in older men

The anabolic effects of nutrition on skeletal muscle may depend on adequate skeletal muscle perfusion, which is impaired in older people. Cocoa flavanols have been shown to improve flow-mediated dilation, an established measure of endothelial function. However, their effect on muscle microvascular blood flow is currently unknown. Therefore, the objective of this study was to explore links between the consumption of cocoa flavanols, muscle microvascular blood flow and muscle protein synthesis (MPS) in response to nutrition in older men. To achieve this objective leg blood flow (LBF), muscle microvascular blood volume (MBV) and MPS were measured under postabsorptive and postprandial (I.V glamin, dextrose to sustain glucose ~7.5 mmol·l-1) conditions in 20 older men. Ten of these men were studied with no cocoa flavanol intervention and a further 10 were studied with the addition of 350 mg of cocoa flavanols at the same time as nutrition began. Leg [femoral artery] blood flow was measured by Doppler ultrasound, muscle MBV by contrast-enhanced ultrasound (CEUS) using DefinityTM perflutren contrast agent and MPS using [1, 2-13C2] leucine tracer techniques. Our results show that although older individuals do not show an increase in LBF or MBV in response to feeding, these absent responses are apparent when cocoa flavanols are given acutely with nutrition. However this restoration in vascular responsiveness is not associated with improved MPS responses to nutrition. We conclude that acute cocoa flavanol supplementation improves muscle macro- and microvascular responses to nutrition, independently of modifying muscle protein anabolism

Feasibility assessment of patient reporting of symptomatic adverse events in multicenter cancer clinical trials

IMPORTANCE: In cancer clinical trials, symptomatic adverse events (AEs), such as nausea, are reported by investigators rather than by patients. There is increasing interest to collect symptomatic AE data via patient-reported outcome (PRO) questionnaires, but it is unclear whether it is feasible to implement this approach in multicenter trials. OBJECTIVE: To examine whether patients are willing and able to report their symptomatic AEs in multicenter trials. DESIGN, SETTING, AND PARTICIPANTS: A total of 361 consecutive patients enrolled in any 1 of 9 US multicenter cancer treatment trials were invited to self-report 13 common symptomatic AEs using a PRO adaptation of the National Cancer Institute’s Common Terminology Criteria for Adverse Events (CTCAE) via tablet computers at 5 successive clinic visits. Patient adherence was tracked with reasons for missed self-reports. Agreement with clinician AE reports was analyzed with weighted κ statistics. Patient and investigator perspectives were elicited by survey. The study was conducted from March 15, 2007, to August 11, 2011. Data analysis was performed from August 9, 2013, to March 21, 2014. RESULTS: Of the 361 patients invited to participate, 285 individuals enrolled, with a median age of 57 years (range, 24-88), 202 (74.3%) female, 241 (85.5%) white, 73 (26.8%) with a high school education or less, and 176 (64.7%) who reported regular internet use (denominators varied owing to missing data). Across all patients and trials, there were 1280 visits during which patients had an opportunity to self-report (ie, patients were alive and enrolled in a treatment trial at the time of the visit). Self-reports were completed at 1202 visits (93.9% overall adherence). Adherence was highest at baseline and declined over time (visit 1, 100%; visit 2, 96%; visit 3, 95%; visit 4, 91%; and visit 5, 85%). Reasons for missing PROs included institutional errors in 27 of 48 (56.3%) of the cases (eg, staff forgetting to bring computers to patients at visits), patients feeling “too ill” in 8 (16.7%), patient refusal in 8 (16.7%), and internet connectivity problems in 5 (10.4%). Patient-investigator CTCAE agreement was moderate or worse for most symptoms (most κ < 0.05), with investigators reporting fewer AEs than patients across symptoms. Most patients believed that the system was easy to use (234 [93.2%]) and useful (230 [93.1%]), and investigators thought that the patient-reported AEs were useful (133 [94.3%]) and accurate (119 [83.2%]). CONCLUSIONS AND RELEVANCE: Participants in multicenter cancer trials are willing and able to report their own symptomatic AEs at most clinic visits and report more AEs than investigators. This approach may improve the precision of AE reporting in cancer trials

Identification of cephalometric landmarks in unilateral cleft lip and palate patients: are there alternatives for point A, ANS, and PNS?

Contains fulltext : 69894.pdf (publisher's version ) (Closed access)OBJECTIVE: To test the reliability of some cephalometric measurements in unilateral cleft lip and palate patients. Measurements with A, ANS, and PNS, were compared to measurements performed with alternatives for point A, ANS, and PNS: A1, A2, ANS1, ANS2, and PNS1. PATIENTS: One hundred sixty-four children with complete unilateral cleft lip and palate (UCLP), with a lateral head film taken at age 4 to 6 years. MEAN OUTCOME MEASURES: Intraobserver and interobserver reliability for cephalometric measurements including A, ANS, PNS or their alternatives: Dahlberg errors, systematic errors, and Pearson correlation coefficients were calculated. RESULTS: The measurements using ANS and PNS or their alternatives, were comparable. The systematic error between observers for measurements using A2 was less than for measurements using A or A1. The scatterplot of point A showed a slightly better distribution of the points than the plots of A1 and A2. CONCLUSIONS: Although the landmarks A, ANS, and PNS are hard to trace in UCLP patients with tooth germs in the anterior maxilla, no better landmarks were found in this study. Cephalometric studies using A, ANS, and PNS in UCLP patients should be interpreted with caution

Infant orthopedics and facial growth in complete unilateral cleft lip and palate until six years of age (dutchcleft).

Contains fulltext : 80208.pdf (publisher's version ) (Closed access)OBJECTIVE: To evaluate longitudinally the effect of infant orthopedics (IO) on dentofacial cephalometric variables in unilateral cleft lip and palate (UCLP) patients from 4 to 6 years of age. DESIGN: Prospective two-arm randomized controlled clinical trial in three cleft palate centers in The Netherlands (Dutchcleft trial). PATIENTS: Fifty-four children with complete UCLP. INTERVENTIONS: Patients were divided randomly into two groups. Half of the patients (IO+) had IO until surgical closure of the soft palate at the age of +/-52 weeks; the other half (IO-) received no intervention. MEAN OUTCOME MEASURES: Cephalometric values representing soft tissue, hard tissue, and dental structures, measured on lateral headfilms made at 4 and 6 years of age. RESULTS: In the IO+ group, 21 patients were analyzed; in the IO- group, 20 patients were analyzed at age 4 and 22 at age 6. No differences were found between IO+ and IO-, except for two measurements: The interincisal angle was larger and the mentolabial angle was smaller in the IO+ group. CONCLUSIONS: For infants with UCLP whose surgical management included soft palate repair at 12 months and delayed hard palate closure, cephalometric outcomes at ages 4 and 6 provide no indication for the type of IO used in this study

Aspectos relacionados à qualidade de sementes de coentro Aspects related to coriander seed quality

O coentro é uma hortaliça amplamente consumida no Brasil como condimento, de grande importância socio-econômica. Problemas relacionados ao baixo vigor de sementes e ao estabelecimento da cultura são uma constante nesta espécie. No presente trabalho 11 lotes comerciais de sementes de coentro das cultivares Verdão, Americano Gigante, Tapacurá, Tabocas, Palmeira e Asteca foram analisados quanto a pureza, germinação, vigor e qualidade sanitária. Em outro estudo, avaliaram-se os efeitos das temperaturas de 15; 20; 25; 30 e 35ºC sobre a germinação das sementes das mesmas cultivares do experimento anterior e mais a cultivar Verdão HV. Houve variação relativamente pequena da germinação entre os lotes e com valores superiores ao padrão nacional para comercialização de sementes. Apenas o lote 1 apresentou pureza abaixo do referido padrão. A qualidade das sementes de coentro comercializadas pelas empresas de sementes no país é, geralmente, satisfatória. Quanto à sanidade, foi detectada a presença de alguns fungos de importância para a cultura do coentro, como Alternaria alternata e Alternaria radicina, com índices de associação elevados. Em um lote, foi detectada a presença de Alternaria dauci. Verificou-se efeito significativo da temperatura, de cultivar e da interação entre a cultivar e temperatura na germinação das sementes. Temperaturas entre 15 e 25ºC proporcionaram maior germinação, enquanto as temperaturas mais elevadas foram prejudiciais. As cultivares 'Verdão HV' e 'Palmeira' germinaram satisfatoriamente a 30ºC. Praticamente não ocorreu germinação a 35ºC para todas as cultivares avaliadas.<br>Coriander is a vegetable crop with large consumption in Brazil, of high social and economic importance. Problems related to low seed vigor and cultivation are reported in this crop. In the present study, eleven seed lots of coriander cultivars 'Verdão', 'Americano Gigante', 'Tapacurá', 'Tabocas', 'Palmeira' and 'Asteca' were used to determine the purity, germination, vigor and pathological seed quality. In another study, effects on seed germination of the same commercial cultivars and 'Verdão HV' were evaluated at temperatures of 15; 20; 25; 30 and 35ºC. Little variation in the germination was observed among seed lots. All lots exhibited germination above the national standard, and lot 1 presented purity below the standard for seed trading. Purity and germination of coriander seeds in Brazil is generally, satisfactory. Regarding to pathological seed quality, some important fungi of coriander crop were detected, as Alternaria alternata and Alternaria radicina. In one lot was detected Alternaria dauci. Effects of temperature, cultivar and an interaction effect between cultivar and temperature on seed germination was observed. Temperatures between 15 and 25ºC were favorable to germination whereas higher temperatures reduced the germination. The cultivars 'Verdão HV' and 'Palmeira' germinated at 30ºC. At 35ºC no germination was observed in all tested cultivars, possibly due to thermoinhibition, since the seeds germinated when transferred to 20ºC