The SU.FOL.OM3 Study: a secondary prevention trial testing the impact of supplementation with folate and B-vitamins and/or Omega-3 PUFA on fatal and non fatal cardiovascular events, design, methods and participants characteristics

<p>Abstract</p> <p>Background</p> <p>During the last decades, many basic and clinical research have pointed to the role of B vitamins (folate, vitamins B6 and B12) and n-3 fatty acids as nutritional factors that might have a protective effect on the development of cardiovascular diseases (CVD).</p> <p>Methods/design</p> <p>The SU.FOL.OM3 (SUpplementation with FOlate, vitamin B6 and B12 and/or OMega-3 fatty acids) trial is a randomized double-blind, placebo-controlled, secondary-prevention trial designed to test the efficacy of 5-methyl tetra-hydro-folates (5-MTHF) supplementation, in combination with vitamin B6 and B12 and/or n-3 fatty acids, at nutritional doses, on fatal and non fatal ischemic CVD in a 2 × 2 factorial design. A total of 2501 patients aged between 45 and 80 years who had a past history, in the previous year, of myocardial infarction (n = 1151) or instable angina pectoris (n = 711) or an ischemic stroke (n = 639) were included. Subjects have to be supplemented and followed up for five years. Daily supplementation comprised nutritional doses of 5-MTHF (560 μg), vitamin B6 (3 mg) and B12 (20 μg) and/or n-3 fatty acids (600 mg with an EPA:DHA ratio of 2:1). A factorial design 2 × 2 has been applied to investigate the separate effects of the B-vitamins, and the n-3 fatty acids, as well as their interaction as compared to the placebo.</p> <p>The primary endpoint is a combination of myocardial infarction, ischemic stroke and cardiovascular death. Secondary endpoints are events of the composite endpoint taken separately, total mortality, and other cardiovascular events such as acute coronary syndromes, coronary revascularization, cardiac failure, arrhythmia...</p> <p>Conclusion</p> <p>Baseline socio-demographic and medical characteristics of participants are totally comparable in the four randomized groups.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN41926726</p

Impact of cancer occurrence on health-related quality of life: A longitudinal pre-post assessment

BACKGROUND: Investigations focusing and implementing on the impact of cancer on health-related quality of life (HRQoL) by the way of a mean comparison between cancer patients and subjects from the general population, are scarce and usually cross-sectional. Longitudinal application of HRQoL instruments to a general, initially healthy population allows for change to be assessed as an event occurs, rather than afterwards. The objective of the present study was to investigate the impact of new cancer on HRQoL. METHODS: The 36-item Short Form (SF-36) and 12-item General Health Questionnaire (GHQ-12) were applied to the French SU.VI.MAX cohort in 1996 and 1998. A controlled longitudinal study was used to determine the impact on HRQoL of newly diagnosed cancer: 84 patients with cancer that occurred between the 2 HRQoL measures were compared with 420 age- and sex-matched cancer-free controls. RESULTS: Initial HRQoL level was similar in the two groups. A new cancer had a particularly marked effect on the SF-36 Physical functioning, Role-physical and General health dimensions (more than 6.6-point difference in change in HRQoL evolution on a 0–100 scale). The Bodily pain and Vitality dimensions were less severely affected (difference in change varying from 4.4 to 6.3 points), and there was no effect on either the GHQ-12 score or the SF-36 Mental health, Role-emotional and Social functioning dimensions. CONCLUSIONS: The negative impact of cancer on the lives of patients was assessed in terms of HRQoL. The aspects most likely to be affected were those with a physical component, and general health perceptions. These results can thus help quantify the impact of a new cancer on HRQoL evolution and potentially facilitate early intervention by identifying the most affected HRQoL domains

Cuidado que brinda la madre ante reacciones post vacunación de niños menores de un año en un C. S. Piura 2023

La presente investigación tuvo como propósito conocer los cuidados que brinda la madre frente a las reacciones post vacunales de los infantes pequeños de un año del servicio de inmunizaciones del Centro de Salud La Unión, Piura 2023. Este estudio tiene un enfoque cuantitativo, diseño no experimental, descriptivo transversal -seccional, porque se puede usar para mostrar un estudio que fue completamente hecho en un tiempo y espacio específico. El universo quedó integrado por 60 madres del centro de salud La Unión, Piura 2021 que brindaron cuidados ante las reacciones post vacunales de los niños menores de un año, y la muestra estuvo conformada por 52 madres. Los datos obtenidos de la encuesta fueron ingresados al programa estadístico IBM SPSS versión 26.0, los datos fueron trasladados al programa estadístico Excel 2022. Los resultados obtenidos: Se constató muchas veces que el cuidado brindado por las madres fue comparado en la extensión cognoscitiva. El 65% de los niños menores de un año tuvieron reacciones posvacunales adecuadas. En la dimensión cultural, se encontró que el tratamiento de las madres en las reacciones sistémicas posvacunales en menores de un año fue el más adecuado, 54%. Y como conclusión generalmente se puntualizó que el 69% del servicio de vacunación del Centro de Salud La Unión de Piura 2021 fue suficiente para atención materna frente a reacciones post vacunales en pequeños de un año.Tesi

Effects of B vitamins and omega 3 fatty acids on cardiovascular diseases: a randomised placebo controlled trial

Objective To investigate whether dietary supplementation with B vitamins or omega 3 fatty acids, or both, could prevent major cardiovascular events in patients with a history of ischaemic heart disease or stroke

Consumers’ food choices, understanding and perceptions in response to different front-of-pack nutrition labelling systems in Belgium : results from an online experimental study

Background Front-of-pack nutrition labels (FoPLs) are increasingly implemented by governments internationally to support consumers to make healthier food choices. Although the Nutri-Score FOPL has officially been implemented in Belgium since April 2019, no study has been conducted before its implementation to compare the effectiveness of different FOPLs. Methods The aim of this study was to compare food choices, objective understanding and perceptions of Belgian consumers in response to five different FOPLs, currently implemented in different countries internationally, namely the Health Star Ratings (HSR), the Multiple Traffic Lights (MTL), Nutri-Score, Guideline Daily Amounts (GDA), and Warning symbols. During the summer 2019, 1007 Belgian consumers were recruited and randomized to one of the five different FOPLs. Through an online questionnaire they were asked to choose one of three different foods within each of three categories (pizzas, cakes, breakfast cereals), as well as rank those same three foods according to nutritional quality, in the condition without as well as with FOPL. In addition, various questions were asked on their perceptions in relation to the FOPL they were exposed to. Results Perceptions of consumers were favorable for all FOPLs with no significant differences between the different FOPLs. There were no significant differences in food choices among the different FOPLs, but Nutri-Score performed best for ranking food products according to nutritional quality. Conclusions While there were no significant differences among different FOPLs for food choices and perceptions, the Nutri-Score was the most effective FOPL in informing Belgian consumers of the nutritional quality of food products

Nutri-Score and NutrInform Battery: Effects on Performance and Preference in Italian Consumers

In May 2020, the European Commission announced a proposal for a mandatory front-of-pack label (FoPL) for all European Union (EU) countries. Indeed, FoPLs have been recognized by several public institutions as a cost-effective measure to guide consumers toward nutritionally favorable food products. The aim of this study was to compare the performance and consumer preference of two FoPLs currently proposed or implemented in EU countries, the interpretive format Nutri-Score and the non-interpretive format NutrInform Battery, among Italian consumers. The experimental study was conducted in 2021 on a representative sample of 1064 Italian adults (mean age = 46.5 +/- 14.1 years; 48% men). Participants were randomized to either Nutri-Score or NutrInform and had to fill out an online questionnaire testing their objective understanding of the FoPL on three food categories (breakfast products, breakfast cereals and added fats) as well as purchase intention, subjective understanding and perception. Multivariable logistic regressions and t-tests were used to analyze the answers. In terms of the capacity of participants to identify the most nutritionally favorable products, Nutri-Score outperformed NutrInform in all food categories, with the highest odds ratio being observed for added fats (OR = 21.7 [15.3-31.1], p &lt; 0.0001). Overall, with Nutri-Score, Italian participants were more likely to intend to purchase nutritionally favorable products than with NutrInform (OR = 5.29 [4.02-6.97], p &lt; 0.0001). Focusing on olive oil, participants of the Nutri-Score group had higher purchase intention of olive oil compared to those in the NutrInform group (OR = 1.92 [1.42-2.60], p &lt; 0.0001) after manipulating the label. The interpretive format Nutri-Score appears to be a more efficient tool than NutrInform for orienting Italian consumers towards more nutritionally favorable food choices

Complex Regional Pain Syndrome. The importance of early diagnosis

A propósito de un caso[ES] El síndrome de dolor regional complejo es una enfermedad de etiopatogenia poco conocida que se desarrolla tras un fenómeno nocivo desencadenante y que se manifiesta por dolor espontáneo o alodinia/hiperalgesia no limitado a la distribución territorial de un nervio periférico y desproporcionado al episodio desencadenante. Se presenta un caso que evoluciona con dolor mantenido en el tiempo, cambios tróficos e impotencia funcional pese al uso de múltiples técnicas terapéuticas. El diagnóstico precoz y el tratamiento temprano son fundamentales para conseguir una evolución favorable y evitar complicaciones discapacitantes. [EN] Complex regional pain syndrome is a disease of uncertain pathogenesis that develops after a harmful triggering phenomenon and manifests itself by spontaneous pain or allodynia / hyperalgesia, not limited to the territorial distribution of a peripheral nerve and disproportionate to the triggering episode. We present a case that evolves with pain maintained over time, trophic changes and functional impotence despite the use of multiple therapeutic techniques. Early diagnosis and early treatment are essential to achieve a favorable outcome and avoid disabling complications.N

Some aspects of the professional development of Evaluative Medicine of incapacity for work

Artículo de opinión[ES] La medicina evaluadora de incapacidades laborales es aquella rama u orientación de la medicina evaluadora que tiene por objetivo valorar la repercusión funcional del cuadro clínico de un trabajador, a efectos de que se determine la existencia o no de algún tipo y grado de incapacidad laboral. Es, por tanto, una aplicación práctica de la medicina que queda fuera del ámbito asistencial y que es ejercida, entre otros, por los médicos inspectores adscritos a la Seguridad Social en España. En el momento presente, los autores consideran necesario el desarrollo e implantación en España de unos estudios específicos que cualifiquen para la práctica de esta rama de la medicina, que pueden encajar como una modalidad de área de capacitación específica para diferentes especialidades médicas, buscando así dotar del mayor rigor científico en las evaluaciones médicas. Igualmente consideran necesaria, en el ámbito médico de la Seguridad Social, el desarrollo de oportunidades de ascenso y expectativas de progreso profesional conforme a los principios de igualdad, mérito y capacidad, lo que implica un sistema de carrera profesional. [EN] Evaluative Medicine of incapacity for work is a branch or orientation of Medicine that aims to assess the functional repercussions of a worker’s clinical picture, for the purpose of determining whether there is some type and degree of work disability. It is, therefore, a practical application of Medicine that is outside the scope of health care and is carried out, among others, by the medical officers assigned to the Social Security (National Health Service) in Spain. At the present time, the authors consider it necessary to develop and implement specific studies in Spain to qualify for the practice of this branch of Medicine, which could fit in as a specific training area for different medical specialties, thus seeking to provide greater scientific rigor in medical evaluations. They also deem it necessary, in the medical field of Social Security, to develop opportunities for promotion and expectations of professional progress in accordance with the principles of equality, merit and ability, which are implied in a professional career system.N

Promoter sequence of Shiga Toxin II (Stx2) is recognized in vivo leading to the production of biologically active Stx2

Shiga toxins (Stxs) are the main agent responsible for the development of hemolytic uremic syndrome (HUS), the most severe and life-threatening systemic complication of infection with enterohemorrhagic Escherichia coli (EHEC) strains. We previously reported Stx2 expression by eukaryotic cells after they were transfected in vitro with the stx2 gene cloned into a prokaryotic plasmid (pStx2). The aim of this study was to evaluate whether mammalian cells were also able to express Stx2 in vivo after pStx2 injection. Mice were inoculated by hydrodynamic based transfection (HBT) with pStx2. We studied the survival, the percentage of polymorphonuclear leukocytes in plasma, plasma urea levels and histology of the kidney and the brain of mice. Mice displayed a lethal dose-response to pStx2. Stx2-mRNA was recovered from the liver and Stx2 cytotoxic activity was observed in plasma of mice injected with pStx2. Stx2 was detected by immunofluorescence in the brains of mice inoculated with pStx2, and markers of central nervous system (CNS) damage were observed, including increased expression of glial fibrillary acidic protein (GFAP) and fragmentation of NeuN in neurons. Moreover, anti-Stx2B immunized mice were protected against pStx2 inoculation. Our results show that Stx2 is expressed in vivo from the wild stx2 gene, reproducing pathogenic damage induced by purified Stx2 or secondary to EHEC-infection.Fil: Bentancor, Leticia Veronica. Universidad Nacional de Quilmes. Departamento de Ciencia y Tecnología. Laboratorio de Ingeniería Genética y Biología Molecular y Celular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental; ArgentinaFil: Mejias, Maria Pilar. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental; ArgentinaFil: Pinto, Alípio. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Ciencias Fisiológicas; ArgentinaFil: Bilen, Marcos Fabian. Universidad Nacional de Quilmes. Departamento de Ciencia y Tecnología. Laboratorio de Ingeniería Genética y Biología Molecular y Celular; ArgentinaFil: Meiss, Roberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental; ArgentinaFil: Rodriguez Galan, Maria Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - CONICET - Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Baez, Natalia Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - CONICET - Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Pedrotti, Luciano Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - CONICET - Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Goldstein Raij, Jorge. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Ciencias Fisiológicas. Laboratorio de Fisiopatogenia; ArgentinaFil: Ghiringhelli, Pablo Daniel. Universidad Nacional de Quilmes. Departamento de Ciencia y Tecnología. Laboratorio de Ingeniería Genética y Biología Molecular y Celular; ArgentinaFil: Palermo, Marina Sandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; Argentin