Direct-acting antivirals used in HCV-related liver disease do not affect thyroid function and autoimmunity

Purpose It is well known that interferon-alpha (IFN-alpha), used for long time as the main therapy for HCV-related disease, induces thyroid alterations, but the impact of the new direct-acting antivirals (DAAs) on thyroid is not established. Aim of this prospective study was to evaluate if DAAs therapy may induce thyroid alterations.Methods A total of 113 HCV patients, subdivided at the time of the enrollment in naive group (n = 64) and in IFN-alpha group (n = 49) previously treated with pegylated interferon-alpha and ribavirin, were evaluated for thyroid function and autoimmunity before and after 20-32 weeks of DAAs.Results Before starting DAAs, a total of 8/113 (7.1%) patients showed Hashimoto's thyroiditis (HT) all belonging to IFN-alpha group (8/49, 16.3%), while no HT cases were found in the naive group. Overall, 7/113 (6.2%) patients were hypothyroid: 3/64 (4.7%) belonging to naive group and 4/49 (8.2%) to IFN-alpha group. Furthermore, a total of 8/113 patients (7.1%) showed subclinical hyperthyroidism: 2/64 (3.1%) were from naive group and 6/49 (12.2%) from IFN-alpha group. Interestingly, after DAAs therapy, no new cases of HT, hypothyroidism and hyperthyroidism was found in all series, while 6/11 (54.5%) patients with non-autoimmune subclinical thyroid dysfunction became euthyroid. Finally, the only association between viral genotypes and thyroid alterations was genotype 1 and hypothyroidism.Conclusions This study supports evidence that DAAs have a limited or missing influence on thyroid in patients with HCV-related diseases. Moreover, it provides preliminary evidence that subclinical non-autoimmune thyroid dysfunction may improve after HCV infection resolution obtained by DAAs

A Case of Unilateral Dermopathy Possibly Related to Graves' Disease

Background: The pathogenesis of the extrathyroidal manifestations of Graves' disease (GD) is not fully clarified. According to the most common hypothesis, they would reflect an autoimmune reaction against antigens constitutively expressed by the thyroid and by the extrathyroidal affected tissues. According to another hypothesis, the so-called Kriss' hypothesis, soluble autoantigens released from the thyroid would reach the affected tissues, where they would become the target of the immune system. In this regard, a shift in gravity during sleep may favour antigen deposition. Case Report: A 59-year old man with GD came to our observation because of a dermopathy. He had been treated with radioactive iodine for Graves' hyperthyroidism and with glucocorticoids and orbital decompression for a bilateral Graves' orbitopathy (GO). The patient complained of a monolateral, untreated dermopathy, affecting the left leg and hand. At physical examination the skin of the left pretibial area and of the dorsal surface of the left hand appeared red and thickened, with an orange peel aspect. Interestingly, the patient reported that he usually slept laying on the left side of his body. Discussion: The observation of a patient with a monolateral dermopathy somehow reports to the Kriss' hypothesis, especially in view of the patient's habit of sleeping on the same side as dermopathy was present. Of course, this does not represent a proof that the Kriss' hypothesis is correct, but it carries an element in favour of it. The fact that GO was bilateral is somehow against it, but does not exclude this possibility

Professional football training strategies during home confinement in the COVID-19 pandemic

ABS T R A C T BACKGROUND: SARS-CoV-2 emergency forced athletes to train at home on their own and mostly unsupervised, making it difficult to provide training solutions. The aims of the study were 1) to collect data and experiences from a Serie A male football team, a top-level female football team and a male young elite football team; 2) to compare data from lockdown and pre-lockdown period; 3) to report changes in training strate-gies adopted to overcome logistical constraints and 4) to evaluate their congruence to cardio, strength and stretching recommendation mentioned above; 5) to report compliance through player daily feedback.METHODS: Three different professional football teams were enrolled. From March 16, 2020 to April 13, 2020, data for each team were re-corded weekly and compared to a standard training period (October 15th to November 15th, 2019) from the same groups. The rate of perceived exertion (RPE), Visual Analogue Scale (VAS) and Total Quality of Recovery Scale (TQR) values were used to compare the two periods using The Student t-Test and Pearson Test.RESULTS: Each group chose a different training approach. Between the pre-lockdown and the lockdown period, there was no significant differ-ence in the VAS, TQR and RPE indexes. Other else players' compliance differed between the groups during the lockdown period.CONCLUSIONS: Most athletes maintained a high level of training during the COVID-19 forced isolation, thanks to the help of team athletic trainers who provide functional tools and indications customized for each differ. Athletes' feedback and compliance differed according to their gender and age. Monitoring with live video sessions and social group sharing among younger players improved compliance and aggregation

Colorectal cancer susceptibility: apparent gender-related modulation by ABCB1 gene polymorphisms

Background: The ATP-binding cassette transporter B1 (ABCB1) gene codes for a membrane efflux pump localized in epithelial cells. Together with other Permeability-glycoproteins in the small and large intestine, its product represents a barrier against xenobiotics, bacterial toxins, drugs and other substances introduced with diet, including carcinogens. The aim of this investigation was to verify the possible contribution of ABCB1 single nucleotide polymorphisms (SNPs) to the genetic risk of colorectal cancer (CRC). Results: DNA obtained from the peripheral blood of 98 CRC patients and 100 healthy controls was genotyped for the three selected SNPs: 1236C > T (rs1128503), 2677G > T/A (rs2032582), and 3435C > T (rs1045642). Molecular data were analyzed to asses allele and haplotype association with CRC. No evidence of an association between ABCB1 alleles and CRC occurrence as a whole was found. However, ABCB1 showed either association with carcinoma of the sigmoid colon, and appeared able to influence the sex ratio among CRC patients. These two effects seemed to act independently based on multivariate analysis. We showed that ABCB1 polymorphisms were able to influence CRC susceptibility related to tumor localization and patient gender. Conclusions: We suggest that sensitivity to undetermined risk factors could depend on the genetic background of ABCB1 locus, with a mechanism that also depends on patient gender

Teachers’ Perception of Information and Communication Technology Integration in Teaching Primary Learners

This researched assessed the early childhood education teachers’ perception of the integration of ICT in teaching the learners at Mactan Elementary School and Soong Elementary School of Lapu-Lapu City Division. It employed a descriptive correlational research design utilizing an adapted instrument. A total of 100 teacher participants answered the survey questionnaire. Results showed that the respondents preferred personal Wi-Fi over mobile data and utilized laptops over desktops and smartphones. Moreover, the participants perceived the benefits of ICT in early childhood education as highly beneficial, and the extent of support in using ICT in the teaching process was very high. The test of a significant relationship between the extent of the respondents’ utilization of ICT in the teaching process and the perceived benefits and support was found significant. It is concluded that the extent of integration of ICT in teaching learners was very beneficial in teaching early childhood education. The adoption of the action plans per school is hereby recommended

Glycaemic control during the lockdown for COVID-19 in adults with type 1 diabetes: A meta-analysis of observational studies

Aims: To assess the effects of lockdown due to COVID-19 pandemic on glucose metrics, measured by glucose monitoring systems, in adult individuals with type 1 diabetes. Methods: We conducted a systematic literature search for English language articles from MEDLINE, Scopus and Web of Science up to February 28, 2021, using “diabetes”, “lockdown”, and “glucose” as key search terms. Time in range (TIR) was the main outcome; other metrics were time above range (TAR), time below range (TBR), mean blood glucose (MBG) and its variability (%CV), estimated HbA1c (eA1c) or glucose management indicator (GMI). Results: Seventeen studies for a total of 3,441 individuals with type 1 diabetes were included in the analysis. In the lockdown period, TIR 70–180 mg/dl increased by 3.05% (95% CI 1.67–4.43%; p < 0.0001) while TAR (>180 mg/dL and > 250 mg/dL) declined by 3.39% (−5.14 to −1.63%) and 1.96% (−2.51 to −1.42%), respectively (p < 0.0001 for both). Both TBR < 70 and <54 mg/dL remained unchanged. MBG slightly decreased by 5.40 mg/dL (−7.29 to −3.51 mg/dL; p < 0.0001) along with a reduction in %CV. Pooled eA1c and GMI decreased by 0.18% (−0.24 to −0.11%; p < 0.0001) and a similar reduction was observed when GMI alone was considered (0.15%, −0.23 to −0.07%; p < 0.0001). Sensor use was only slightly but not significantly reduced during lockdown. Conclusions: This meta-analysis shows that well-controlled people with type 1 diabetes on both MDI and CSII with continuous or flash glucose monitoring did not experience a deterioration in glucose control throughout the COVID-19 lockdown, showing a modest, though statistically significant improvement in many glucose control parameters

CDH1 POLYMORPHISMS AND LOW EXPRESSION OF E-CADHERIN AND β-CATENIN IN COLORECTAL CANCER PATIENTS

Epithelial-mesenchymal transition (EMT) process has a central role in tumor progression and metastases. Loss of cell-to-cell adhesiveness is a key step in EMT. In particular, E-cadherin and \u3b2-catenin, components of the adherens junctions, play a strategic role. Accumulation of \u3b2-catenin at cytoplasmic level following adherens junctions disruption, induces its translocation into the nucleus, where it binds to members of the TCF/LEF family of transcription factors. In particular, Lymphoid Enhancer-Binding factor 1 (LEF1) product can target genes involved in EMT. The aim of the present study was to evaluate the influence of CDH1 and CTNNB1 genes, coding for E-cadherin and \u3b2-catenin respectively and LEF1 in a sample study of 140 Italian patients affected by colorectal cancer. An association study between four single nucleotide polymorphisms (rs11865026, rs11642413, rs13689, and rs10431923) of CDH1 and the disease did not provide statistically significant results. The gene expression analysis carried out for CDH1, CTNNB1 and LEF1 in 54 paired specimens from 27 patients provided evidence of a reduced expression of the first two in cancer tissues. We believe there may be a sort of cross regulation between the products of these two genes which closely interact in EMT activation and that such hypothesis should be further investigated in a greater number of cases

Association of Gut Hormones and Microbiota with Vascular Dysfunction in Obesity

In the past few decades, obesity has reached pandemic proportions. Obesity is among the main risk factors for cardiovascular diseases, since chronic fat accumulation leads to dysfunction in vascular endothelium and to a precocious arterial stiffness. So far, not all the mechanisms linking adipose tissue and vascular reactivity have been explained. Recently, novel findings reported interesting pathological link between endothelial dysfunction with gut hormones and gut microbiota and energy homeostasis. These findings suggest an active role of gut secretome in regulating the mediators of vascular function, such as nitric oxide (NO) and endothelin-1 (ET-1) that need to be further investigated. Moreover, a central role of brain has been suggested as a main player in the regulation of the different factors and hormones beyond these complex mechanisms. The aim of the present review is to discuss the state of the art in this field, by focusing on the processes leading to endothelial dysfunction mediated by obesity and metabolic diseases, such as insulin resistance. The role of perivascular adipose tissue (PVAT), gut hormones, gut microbiota dysbiosis, and the CNS function in controlling satiety have been considered. Further understanding the crosstalk between these complex mechanisms will allow us to better design novel strategies for the prevention of obesity and its complications

Metabolic profiling of visceral adipose tissue from obese subjects with or without metabolic syndrome

Obesity represents one of the most complex public health challenges and has recently reached epidemic proportions.  Obesity is also considered to be primarily responsible for the rising prevalence of metabolic syndrome, defined as the coexistence in the same individual of several risk factors for atherosclerosis, including dyslipidaemia, hypertension and hyperglycaemia, as well as for cancer. Additionally, the presence of three of the five risk factors (abdominal obesity, low HDL cholesterol, high triglycerides, high fasting glucose and high blood pressure) characterizes metabolic syndrome, which has serious clinical consequences.  The current study was conducted in order to identify metabolic differences in visceral adipose tissue collected from obese (BMI 43-48) human subjects who were diagnosed with metabolic syndrome, obese individuals who were metabolically healthy and non-obese healthy controls. Extensive gas chromatography/mass spectrometry (GC/MS) and liquid chromatography/mass spectrometry (LC/MS/MS) analyses were used to obtain the untargeted visceral adipose tissue metabolomics profiles of 481 metabolites belonging to all biochemical pathways. Our results indicated consistent increases in oxidative stress markers from the pathologically obese samples in addition to subtle markers of elevated glucose levels that may be consistent with metabolic syndrome. In the tissue derived from the pathologically obese subjects, there were significantly elevated levels of plasmalogens, which may be increased in response to oxidative changes in addition to changes in glycerol-phosphorylcholine, glycerol-phosphorylethanolamine glycerol-phosphorylserine, ceramides and sphingolipids. These data could be potentially helpful for recognizing new pathways that underlie the metabolic-vascular complications of obesity and may lead to the development of innovative targeted therapies