Comparison of Plasma Concentrations for Some Biological Markers in Patients with Type 2 Diabetes Before and After Consuming a Vegetarian Diet

Background: The prevalence of diabetes mellitus has been increasing worldwide in recent years. Long-term diabetes results in vascular changes and dysfunction. Complications of diabetes are the major causes of morbidity and mortality in diabetic patients. [1] Renal involvement is an important complication of diabetes mellitus. End-stage kidney with renal failure accounts for deaths in more than 10% of all diabetics. [2] Diet therapy is fundamentally important for both diabetes and diabetic kidney disease (DKD) to maintain glucose control and suppress the progression of renal damage.[3] The main nutrition-related goals for people with chronic kidney disease (CKD) involve the slowing of kidney failure progression rate and minimizing uremic toxicity and metabolic disorders of kidney failure, diminishing proteinuria, maintaining good nutritional status, and lowering the risk of secondary complications including cardiovascular disease, bone disease, and disturbed blood pressure control [4]. The aim of our study was to compare some biological markers in patients with type 2 diabetes whom are at risk of developing kidney failure, before and after starting a vegetarian diet for at least 30 days. Materials & Methods: In this study we measured plasma concentrations of Urea, Creatinine, Fasting Glucose, and calculated EGFR according to Cockcroft-Gault equation for of 20 patients with type 2 diabetes (5 males, 15 females), with an average age of 63 years. Blood-sampling and testing was conducted in two time periods. The first one was at the regular diet for subjects consuming all kind of foods including proteins of animal and plant sources, the second one was after at least 30 days of fasting involves abstention from all animal products (Easter Fasting). Results: Plasma Urea was significantly lower after the diet (mean ± SD: 27 ± 11 mg/dl) than before diet (mean ± SD: 42 ± 23.55 mg/dl). Using student’s t-test P was: 0.001 ˂ 0.05. Plasma Creatinine was significantly lower after the diet (mean ± SD: 1.09 ± 0.25 mg/dl) than before diet (mean ± SD: 1.2 ± 0.3 mg/dl). Using student’s t-test P was: 0.022 ˂ 0.05. Plasma Glucose was lower after the diet (mean ± SD: 126 ± 52.15 mg/dl) than before diet (mean ± SD: 140 ± 67.44 mg/dl). Using student’s t-test P was: 0.108 ˃ 0.05. EGFR was higher after the diet (mean ± SD: 71.45 ± 26.2 ml/min) than before diet (mean ± SD: 69.45 ± 25.54 ml/min). Using student’s t-test P was: 0.039 ˂ 0.05. Conclusion: These results may indicate that the vegetarian diet could be a kidney protective for patients with type 2 diabetes. DOI: 10.7176/CMR/11-6-04 Publication date: August 31st 201

Retention of Mechanical Properties After Water Immersion for Glass-Fibre Polymer Composite Laminates with Thermoset & Thermoplastic Infusible Resins

In this work, we conducted an extensive comparative study of the water absorption behavior and retention of mechanical properties of a group of GRP composite laminates manufactured with a range of infusible thermosetting and thermoplastics resins. All laminates were manufactured by Vacuum-Assisted Resin Transfer Moulding (VARTM; the most relevant manufacturing technique in shipbuilding) with a range of state-of-the-art thermosetting resins (Urethane acrylate Crestapol 1210, Epoxy SR1125, Bio-epoxy Supersap CLR, Phenolic Cellobond J2027X) and a novel infusible acrylic thermoplastic resin (Acrylic Elium 150). The reinforcement of choice for each laminate was a unidirectional glass fabric of 996 gsm. Sample preparation for water immersion studies was according to ASTM D5229. This study was part of a comprehensive down-selection of commercially available resins in terms of their suitability for shipbuilding applications, as part of the EU H2020 project FIBRESHIP2 .  A selection of relevant properties of the laminates with different resin systems is presented in this paper including fibre volume fraction, apparent interlaminar shear strength (dry and wet condition), flexural strength (dry and wet condition) and flexural modulus (dry and wet condition)

Bio-based epoxy resin systems as potential alternatives to petroleum based epoxy matrices in marine fibre-reinforced polymer composites

Fibre-reinforced polymers (FRP) are extensively used in the marine industry for the manufacture of lightweight hull structures for vessels up to 50m in length, and for secondary structures and components in larger vessels. The main benefits resulting in the application of FRP in shipbuilding include: significant weight reduction resulting in substantial fuel saving, increase in cargo capacity and subsequent reduction of greenhouse gas emissions, improved life cycle performance and reduced maintenance costs due to corrosion resistance. As the use of thermoset polymers in shipbuilding increases, so too does the interest in finding suitable alternatives to the use of petroleum-based raw materials. Much work has been published on bio-based epoxy resin systems from natural raw materials, such as vegetable oils, however, the mechanical performance of the bio-based resin systems in comparison to equivalent petroleum-based systems is not widely documented. This research focusses on the comparison of petroleum-based and bio-based two-part commercial epoxy resin systems to manufacture glass fibre reinforced polymers (GFRP) for marine applications. Laminates were manufactured using the Vacuum Assisted Resin Transfer Moulding (VARTM) manufacturing process. Specimens were mechanically characterised in order to evaluate fibre volume fraction, density, apparent inter-laminar shear strength, flexural modulus and strength. The effect of water ingress on the mechanical properties of laminates was also studied by soaking samples in water at 35°C for 28 days. Specimen quality and fracture surfaces were assessed using optical and scanning electron microscopy. Initial results have shown that the average apparent inter-laminar shear strength of the petroleum-based samples was almost identical to the bio-based samples (within 1%), while the flexural strength and modulus of the petroleum-based samples was only 6% and 7% higher than the bio-based samples. Despite the comparatively good mechanical performance of the bio-based laminate, the high viscosity of the resin resulted in higher infusion temperatures and longer infusion times than for the petroleum-based epoxy

Radiographic preoperative templating of extra-offset cemented THA implants: How reliable is it and how does it affect survival?

SummaryIntroductionSecuring femoral offset should in theory improve hip stability and abductor muscles moment arms. As problems arise mainly in case of originally increased offset (>40mm), a range of extra-offset stems is available; the exact impact in terms of fixation, however, is not known.HypothesisExtra-offset stems should more reliably reestablish original femoral offsets exceeding 40mm than standard femoral components, limiting instability risk without possible adverse effect on fixation.ObjectiveTo compare the ability of five commonly available femoral stem designs to restitute offset exceeding 40mm, and to assess function and cement fixation at a minimum 6 years’ follow-up in a stem conceived to reproduce such offset.Patients and methodsA continuous series of 74 total hip replacements (THR) in hips with increased (>40mm) femoral offset was studied. All underwent preoperative X-ray templating on Imagika™ software to assess offset reproduction by five models of stem: four standard, and one Lubinus SP2™ extra-offset stem. A retrospective clinical and X-ray study was conducted with a minimum 6 years’ follow-up on the Lubinus SP2™ 117° stems used to try to reproduce offset in the 74 THRs.ResultsApart from the increased (>40mm) offset, the cervicodiaphyseal angle was consistently <135°, <130° in 60 femurs (81%) and <125° in 45 (60%). Planning showed the four standard stems to induce (>5mm femoral offset reduction in 50–83% of cases, versus only 25% with the Lubinus SP2™ 117°). All 74 hips received Lubinus SP2™ 117° stems: at a mean 78 months FU (range, 70–94mo), their mean Postel-Merle d’Aubigné score was 17±1.8 (range, 13–18). Five of the 74 THRs underwent surgical revision: three cases of loosening, in which the stem was replaced, and two of instability, without change of stem. Loosening was not related to offset reproduction quality; two of the three cases were due to initial cementing defect, and the third occurred in a femur with previous history of two osteotomies. There were four cases of dislocation (5.4%: two primary, which were not operated on, and two recurrent, managed by acetabular revision), despite good reproduction of the preoperative offset in three of the four cases. Mean 7-year implant survivorship was 95.1% (±4.8).Discussion and conclusionThe anatomic form of the Lubinus™ SP2 117° should in theory provide a uniform cement mantle. Survivorship, however, is less good than for regular offset versions (126° or 135°). On the other hand, it does reproduce anatomy in case of >40mm offset, providing extra offset of more than 51mm. The slightly shorter survivorship requires more long-term surveillance.Level of evidenceLevel IV, retrospective study

COVID-19 burden differed by city districts and ethnicities during the pre-vaccination era in Amsterdam, the Netherlands

BackgroundDuring the first wave of COVID-19 in Amsterdam, the Netherlands, a disproportional number of COVID-19 hospitalizations occurred in individuals with an ethnic minority background and in individuals living in city districts with a lower socioeconomic status (SES). In this study, we assessed whether these disparities continued throughout the second wave, when SARS-CoV-2 testing was available to anyone with symptoms but prior to the availability of COVID-19 vaccination.MethodsSurveillance data on all notified SARS-CoV-2 cases in Amsterdam between 15 June 2020 and 20 January 2021 were matched to municipal registration data to obtain the migration background of cases. Crude and directly age- and sex-standardized rates (DSR) of confirmed cases, hospitalizations, and deaths per 100,000 population were calculated overall, and by city districts, and migration backgrounds. Rate differences (RD) and rate ratios (RR) were calculated to compare DSR between city districts and migration backgrounds. We used multivariable Poisson regression to assess the association of city districts, migration backgrounds, age, and sex with rates of hospitalization.ResultsA total of 53,584 SARS-CoV-2 cases (median age 35 years [IQR = 25–74]) were notified, of whom 1,113 (2.1%) were hospitalized and 297 (0.6%) deceased. DSR of notified infections, hospitalization, and deaths per 100,000 population were higher in lower SES peripheral city districts (South-East/North/New-West) than higher SES central districts (Central/West/South/East), with almost a 2-fold higher hospitalization DSR in peripheral compared to central districts (RR = 1.86, 95%CI = 1.74–1.97). Individuals with a non-European migration background also had a higher COVID-19 burden, particularly with respect to hospitalization rates, with a 4.5-fold higher DSR for individuals with a non-European background compared to ethnic-Dutch (RR 4.51, 95%CI = 4.37–4.65). City districts, migration backgrounds, male gender, and older age were independently associated with COVID-19 hospitalization rates.DiscussionIndividuals with a non-European background and individuals living in city districts with lower SES continued to independently have the highest COVID-19 burden in the second wave of COVID-19 in Amsterdam, the Netherlands

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome