Dietary patterns in relation to hepatic fibrosis among patients with nonalcoholic fatty liver disease

Davood Soleimani,1 Golnaz Ranjbar,1,2 Reza Rezvani,1,3 Ladan Goshayeshi,4 Farkhonde Razmpour,1 Mohsen Nematy1 1Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; 2Department of Biological and Environmental Sciences, Faculty of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; 3School of Nutrition, Faculté des Sciences de l’agriculture et de l’alimentation, Université Laval, Quebec, QC, Canada; 4Department of Gastroenterology and Hepatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Background: Nonalcoholic fatty liver disease (NAFLD) is a multifactorial disorder that can progress to fibrosis. Several dietary patterns have been associated with histological features of NAFLD. However, little is known about the association between dietary patterns and hepatic fibrosis. Purpose: The current study aimed at identifying the relationship between major dietary patterns and hepatic fibrosis among patients with NAFLD. Subjects and methods: This cross-sectional study included 170 eligible subjects with NAFLD. Diet was evaluated using three 3-day dietary records during a 1-month period. Hepatic fibrosis was diagnosed using Fibroscan. Western, Iranian, and healthy dietary patterns were extracted using factor analysis. Results: After adjustment for other risk factors, adherence to a Western dietary pattern was associated with the higher odds of fibrosis (OR: 4.21; 95% CI: 1.63–8.31), whereas adherence to a healthy dietary pattern was associated with the lower odds of fibrosis (OR: 0.26; 95% CI: 0.10–0.49). Among main food groups, high intake of red meat, hydrogenated fats, and soft drinks was associated with the higher risk of fibrosis, whereas tea and coffee consumption had a protective role in hepatic fibrosis independent of other risk factors. Conclusion: The adherence to a healthy dietary pattern characterized by high intake of low-fat dairies, white meat, nuts, vegetables, fruits, and vegetable oils combined with coffee and tea consumption might be helpful in the nutritional strategies against hepatic fibrosis. Keywords: liver diseases, NAFLD, fibrosis, factor analysis, diet, dietary patter

Identification and management of Lynch syndrome in the Middle East and North African countries: outcome of a survey in 12 countries

Background: Lynch syndrome (LS), the most common inherited form of colorectal cancer (CRC), is responsible for 3% of all cases of CRC. LS is caused by a mismatch repair gene defect and is characterized by a high risk for CRC, endometrial cancer and several other cancers. Identification of LS is of utmost importance because colonoscopic surveillance substantially improves a patient’s prognosis. Recently, a network of physicians in Middle Eastern and North African (ME/NA) countries was established to improve the identification and management of LS families. The aim of the present survey was to evaluate current healthcare for families with LS in this region. Methods: A questionnaire was developed that addressed the following issues: availability of clinical management guidelines for LS; attention paid to family history of cancer; availability of genetic services for identification and diagnosis of LS; and assessment of knowledge of LS surveillance. Members of the network and authors of recent papers on LS from ME/NA and neighbouring countries were invited to participate in the survey and complete the online questionnaire. Results: A total of 55 individuals were invited and 19 respondents from twelve countries including Algeria, Azerbaijan, Cyprus, Egypt, Iran, Jordan, Kuwait, Lebanon, Morocco, Palestine, Tunisia, and Turkey completed the questionnaire. The results showed that family history of CRC is considered in less than half of the surveyed countries. Guidelines for the management of LS are available in three out of twelve countries. The identification and selection of families for genetic testing were based on clinical criteria (Amsterdam criteria II or Revised Bethesda criteria) in most countries, and only one country performed universal screening. In most of the surveyed countries genetic services were available in few hospitals or only in a research setting. However, surveillance of LS families was offered in the majority of countries and most frequently consisted of regular colonoscopy. Conclusion: The identification and management of LS in ME/NA countries are suboptimal and as a result most LS families in the region remain undetected. Future efforts should focus on increasing awareness of LS amongst both the general population and doctors, and on the improvement of the infrastructure in these countries

Resolved flow simulation of pulverized coal particle devolatilization and ignition in air- and O2/CO2-atmospheres

A resolved laminar flow simulation approach is used to investigate the effect of enhanced oxygen levels on single coal particle ignition, comparing the numerical results against experimental data for well-defined conditions (Molina and Shaddix, 2007). Devolatilization is described by a generic boundary condition at the particle surface that accounts for both convective and diffusive phenomena during pyrolysis. The heating rate history of the particle is obtained by solving for intra-particle heat transfer and heat exchange between the particle and its surroundings. The time evolution of volatile release is captured by using the particle mean temperature to calculate the devolatilization rate from a single kinetic rate law with CPD-fitted parameters. The assumed volatile composition includes both light gases and larger hydrocarbons to represent tars. A skeletal kinetic mechanism for pyrolysis and oxidation of hydrocarbon and oxygenated fuels containing 52 species and 452 reactions is used to accurately describe homogeneous chemistry. Particle heat-up, pyrolysis, ignition and envelope flame stabilization are characterized in four gas atmospheres differing in oxygen content and the use of either N2 or CO2 as balance gas. In agreement with the experimental evidence, enhanced oxygen levels shorten ignition delay time τign and result in a higher intensity of the combustion process according to temperature and radical production peaks for all studied mixtures. For the studied oxy-mixtures the presence of CO2 in substitution of N2 delays ignition. The observed behavior is coherent with the different thermo-physical properties of the gas mixtures. The sensitivity of predicted ignition delay to a set of uncertainties is also discussed. It is found that while the absolute values of predicted ignition delay time are functions of potential particle preheating, particle Reynolds number and the chosen criterion to extract ignition delay, the relative trends among the gas mixtures remain in line with the experimental evidence