35 research outputs found
Is Glycemic Control the Primary Goal in Diabetes Treatment?
The prevalence of Diabetes is steadily increasing, raising public health concerns. Hyperglycemia leads to microvascular and macrovascular diseases through several metabolic and biochemical pathways. Previous clinical trials and observational studies have demonstrated that tight glycemic control can reduce the incidence of diabetic complications, with the greatest benefit shown in younger patients with diabetes of shorter duration and those who have no prior history of cardiovascular disease. Moreover, previous studies highlight the concept of metabolic memory and legacy effect, since controlling diabetes early can have an impact on long-term prognosis of the disease. As to whether it is time to consider shifting the treatment focus for patients with type 2 diabetes from a glucose-centric to a weight-centric or a cardio-centric approach, the dilemma remains theoretical; glucose control, weight loss and effective treatment of metabolic and cardio-vascular co-morbidities are interrelated components of an integrated plan of care that should be addressed simultaneously and effectively
Înternistsâ and Endocrinologistsâ Knowledge and Attitudes Regarding Periodontal Disease, Caries, Xerostomia and Diabetes Mellitus: A National Survey
Objectives: The present study aims to investigate the current knowledge, attitudes and behaviors of clinicians dealing with diabetes regarding the relationship of Diabetes Mellitus (DM) and odostomatological diseases, such as periodontal disease, xerostomia and caries.
Methods: A twenty-four item closed-ended multiple-choice questionnaire was completed by 225 Greek medical doctors. The sample was divided into three groups according to specialty: a) Endocrinologists; b) Internists; c) Internal medicine registrars. Bivarate analysis, Fisher test, and Spearman correlation were used for statistical analysis.
Results: Most doctors were aware of the bi-directional relationship between periodontal disease and DM. Regarding the relationship between DM and xerostomia, 50% of doctors were unaware that patients with DM have an increased risk of xerostomia and were unfamiliar with the relevant studies. Nearly 50% of doctors agreed that patients with diabetes are at increased risk of developing caries. Age, specialty, and years of expertise have an impact on the way of doctors' answer. Finally, 78,6% of doctors treating diabetes should cooperate with dentists to reduce their patients' risk of odontostomatological complications.
Conclusions: The relationship between diabetes and dental problems is often underestimated. Implementation of medical and dental educational programs oriented in increasing inter-professional education as well as collaboration between dentists and doctors dealing with diabetes, are needed in order to achieve the goal of better care of patients with diabetes
Effect of polydispersity and bubble clustering on the steady shear viscosity of semidilute bubble suspensions in Newtonian media
In this work, we examine the steady shear rheology of semidilute polydisperse bubble suspensions to elucidate the role of polydispersity on the viscosity of these systems. We prove theoretically that the effect of polydispersity on suspension viscosity becomes apparent only if the bubble size distribution is bimodal, with very small and very large bubbles having similar volume fractions. In any other case, we can consider the polydisperse suspension as monodisperse, with the average bubble diameter equal to the De Brouckere mean diameter (d43). To confirm the theoretical results, we carried out steady shear rheological tests. Our measurements revealed an unexpected double power-law decay of the suspension relative viscosity at average capillary numbers between 0.01 and 1. To investigate this behavior further, we visualized the produced bubble suspensions under shear. The visualization experiments revealed that bubbles started forming clusters and threads at an average capillary number around 0.01, where we observed the first decay of viscosity. Clustering and alignment have been associated with shear-thinning behavior in particle suspensions. We believe that the same holds for bubble suspensions, where bubble clusters and threads align with the imposed shear flow, reducing the streamline distortions and, in turn, resulting in a decrease in the suspension viscosity. Consequently, we can attribute the first decay of the relative viscosity to the formation of bubble clusters and threads, proving that the novel shear-thinning behavior we observed is due to a combination of bubble clustering and deformation
Dietary, lifestyle and clinicopathological factors associated with BRAF and K-ras mutations arising in distinct subsets of colorectal cancers in the EPIC Norfolk study.
BACKGROUND: BRAF and K-ras proto-oncogenes encode components of the ERK signalling pathway and are frequently mutated in colorectal cancer. This study investigates the associations between BRAF and K-ras mutations and clinicopathological, lifestyle and dietary factors in colorectal cancers. METHODS: 186 adenocarcinomas and 16 adenomas from the EPIC Norfolk study were tested for BRAF and K-ras mutations. Diet and lifestyle data were collected prospectively using seven day food diaries. RESULTS: BRAF V600E mutation was found in 15.6% of colorectal cancers but at higher frequencies in cancers with proximal location, poor differentiation and microsatellite instability (MSI) (all p < 0.001). K-ras mutation (mostly in codons 12 and 13) was found in 22.0% of colorectal cancers but at higher frequencies in cancers of more advanced Dukes' stage (p = 0.001), microsatellite stable (MSS) status (p = 0.002) and in individuals with lower blood high-density lipoprotein concentrations (p = 0.04). Analysis of dietary factors demonstrated no link between BRAF mutation and any specific dietary constituent, however, K-ras mutation was found at higher frequencies in individuals with higher white meat consumption (p < 0.001). Further analysis of specific mutation type demonstrated that G to A transitions in K-ras were observed at higher frequencies in individuals consuming lower amounts of fruit (p = 0.02). CONCLUSION: These data support the model of BRAF and K-ras mutations arising in distinct colorectal cancer subsets associated with different clinicopathological and dietary factors, acting as mutually exclusive mechanisms of activation of the same signalling pathway.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are
Alterations in PTEN and PIK3CA in colorectal cancers in the EPIC Norfolk study: associations with clinicopathological and dietary factors.
BACKGROUND: The PTEN tumour suppressor gene and PIK3CA proto-oncogene encode proteins which contribute to regulation and propagation of signal transduction through the PI3K/AKT signalling pathway. This study investigates the prevalence of loss of PTEN expression and mutations in both PTEN and PIK3CA in colorectal cancers (CRC) and their associations with tumour clinicopathological features, lifestyle factors and dietary consumptions. METHODS: 186 adenocarcinomas and 16 adenomas from the EPIC Norfolk study were tested for PTEN and PIK3CA mutations by DNA sequencing and PTEN expression changes by immunohistochemistry. Dietary and lifestyle data were collected prospectively using seven day food diaries and lifestyle questionnaires. RESULTS: Mutations in exons 7 and 8 of PTEN were observed in 2.2% of CRC and PTEN loss of expression was identified in 34.9% CRC. Negative PTEN expression was associated with lower blood low-density lipoprotein concentrations (p = 0.05). PIK3CA mutations were observed in 7% of cancers and were more frequent in CRCs in females (p = 0.04). Analysis of dietary intakes demonstrated no link between PTEN expression status and any specific dietary factor. PTEN expression negative, proximal CRC were of more advanced Dukes' stage (p = 0.02) and poor differentiation (p < 0.01). Testing of the prevalence of PIK3CA mutations and loss of PTEN expression demonstrated that these two events were independent (p = 0.55). CONCLUSION: These data demonstrated the frequent occurrence (34.9%) of PTEN loss of expression in colorectal cancers, for which gene mutations do not appear to be the main cause. Furthermore, dietary factors are not associated with loss of PTEN expression. PTEN expression negative CRC were not homogenous, as proximal cancers were associated with a more advanced Dukes' stage and poor differentiation, whereas distal cancers were associated with earlier Dukes' stage.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are
Operationalizing the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations: A Standardized Scoring System
Background: Following the publication of the 2018 World Cancer Research Fund (WCRF)
and American Institute for Cancer Research (AICR) Third Expert Report, a collaborative group was
formed to develop a standardized scoring system and provide guidance for research applications.
Methods: The 2018 WCRF/AICR Cancer Prevention Recommendations, goals, and statements of
advice were examined to define components of the new Score. Cut-points for scoring were based
on quantitative guidance in the 2018 Recommendations and other guidelines, past research that
operationalized 2007 WCRF/AICR Recommendations, and advice from the Continuous Update Project
Expert Panel. Results: Eight of the ten 2018 WCRF/AICR Recommendations concerning weight,
physical activity, diet, and breastfeeding (optional), were selected for inclusion. Each component
is worth one point: 1, 0.5, and 0 points for fully, partially, and not meeting each recommendation,
respectively (Score: 0 to 7â8 points). Two recommendations on dietary supplement use and for
cancer survivors are not included due to operational redundancy. Additional guidance stresses the
importance of accounting for other risk factors (e.g., smoking) in relevant models. Conclusions: The
proposed 2018 WCRF/AICR Score is a practical tool for researchers to examine how adherence to the
2018 WCRF/AICR Recommendations relates to cancer risk and mortality in various adult populations.
Postâdiagnosis adiposity, physical activity, sedentary behaviour, dietary factors, supplement use and colorectal cancer prognosis: Global Cancer Update Programme ( CUP Global) summary of evidence grading
Based on the World Cancer Research Fund Global Cancer Update Programme, we performed systematic reviews and metaâanalyses to investigate the association of postâdiagnosis adiposity, physical activity, sedentary behaviour, and dietary factors with colorectal cancer prognosis. We searched PubMed and Embase until 28th February, 2022. An independent expert committee and expert panel graded the quality of evidence. A total of 167 unique publications were reviewed, and all but five were observational studies. The quality of the evidence was graded conservatively due to the high risk of several biases. There was evidence of nonâlinearity in the associations between body mass index and colorectal cancer prognosis. The associations appeared reverse Jâshaped, and the quality of this evidence was graded as limited (likelihood of causality: limitedâno conclusion). The evidence on recreational physical activity and lower risk of allâcause mortality (relative risk [RR] highest vs. lowest: 0.69, 95% confidence interval [CI]: 0.62â0.77) and recurrence/diseaseâfree survival (RR: 0.80, 95% CI: 0.70â0.92) was graded as limitedâsuggestive. There was limitedâsuggestive evidence for the associations between healthy dietary and/or lifestyle patterns (including diets that comprised plantâbased foods), intake of whole grains and coffee with lower risk of allâcause mortality, and between unhealthy dietary patterns and intake of sugary drinks with higher risk of allâcause mortality. The evidence for other exposures on colorectal cancer outcomes was sparse and graded as limitedâno conclusion. Analyses were conducted excluding cancer patients with metastases without substantial changes in the findings. Wellâdesigned intervention and cohort studies are needed to support the development of lifestyle recommendations for colorectal cancer patients
Post-diagnosis adiposity, physical activity, sedentary behaviour, dietary factors, supplement use and colorectal cancer prognosis: Global Cancer Update Programme (CUP Global) summary of evidence grading
Based on the World Cancer Research Fund Global Cancer Update Programme, we performed systematic reviews and meta-analyses to investigate the association of post-diagnosis adiposity, physical activity, sedentary behaviour, and dietary factors with colorectal cancer prognosis. We searched PubMed and Embase until 28th February, 2022. An independent expert committee and expert panel graded the quality of evidence. A total of 167 unique publications were reviewed, and all but five were observational studies. The quality of the evidence was graded conservatively due to the high risk of several biases. There was evidence of non-linearity in the associations between body mass index and colorectal cancer prognosis. The associations appeared reverse J-shaped, and the quality of this evidence was graded as limited (likelihood of causality: limited-no conclusion). The evidence on recreational physical activity and lower risk of all-cause mortality (relative risk [RR] highest vs. lowest: 0.69, 95% confidence interval [CI]: 0.62-0.77) and recurrence/disease-free survival (RR: 0.80, 95% CI: 0.70-0.92) was graded as limited-suggestive. There was limited-suggestive evidence for the associations between healthy dietary and/or lifestyle patterns (including diets that comprised plant-based foods), intake of whole grains and coffee with lower risk of all-cause mortality, and between unhealthy dietary patterns and intake of sugary drinks with higher risk of all-cause mortality. The evidence for other exposures on colorectal cancer outcomes was sparse and graded as limited-no conclusion. Analyses were conducted excluding cancer patients with metastases without substantial changes in the findings. Well-designed intervention and cohort studies are needed to support the development of lifestyle recommendations for colorectal cancer patients