Effectiveness of Mediterranean Diet Implementation in Dry Eye Parameters: A Study of PREDIMED-PLUS Trial

This study was cofounded by grants from the Spanish Ministry of Science-Instituto de Salud Carlos III (PI17/00764) and FEDER funds. The authors wish to thank Ingrid de Ruiter, MBChB, Ph.D., for English language support.The purpose of this study is to evaluate the effect of a Mediterranean diet supplemented with extra virgin olive oil and nuts on dry eye parameters. The participants in this study were randomized into one of the two interventional arms: (1) a standard intervention group, a Mediterranean diet supplemented with extra virgin olive oil and nuts; and (2) an intensive intervention group, based on a hypocaloric Mediterranean diet and an intensive lifestyle program with physical activity and weight-loss goals. In both groups, common dry eye tests were conducted at baseline and after six months: the Ocular Surface Disease Index (OSDI), the Dry Eye Scoring System (DESS), tear break-up time (TBUT), the Schirmer’s test, and the Oxford staining grade. Sixty-seven eyes were examined. After six months, dry eye parameters improved in both groups; differences between groups were favorable for the intensive intervention group. The implementation of a Mediterranean diet pattern was beneficial for the selected patients with dry eye, and could be beneficial for patients with dry eye in general. Behavioral support for diet adherence and the promotion of healthy lifestyles (exercise) and weight loss (calorie restriction) have an added positive effect.Instituto de Salud Carlos III Spanish Government PI17/00764European Union (EU

Measurements of high-energy neutron-induced fission of natPb and 209Bi

EFNUDAT – Measurements and Models of Nuclear ReactionsThe CERN Neutron Time-Of-Flight (n_TOF) facility is well suited to measure low cross sections as those of neutron-induced fission in subactinides. The cross section ratios of natPb and 209Bi relative to 235U and 238U were measured using PPAC detectors and a fragment coincidence method that allows us to identify the fission events. The present experiment provides first results for neutron-induced fission up to 1 GeV. Good agreement is found with previous experimental data below 200 MeV. The comparison with proton-induced fission indicates that the limiting regime where neutron-induced and proton-induced fission reach equal cross sections is close to 1 Ge

Distribution pattern of psoriasis, anxiety and depression as possible causes of sexual dysfunction in patients with moderate to severe psoriasis

BACKGROUND: Psoriasis may significantly impair sexual function. Depression and organic factors appear to play a key role in this relation. However, beyond genital psoriasis, the importance of the disease's distribution patterns has not been considered. OBJECTIVES: To research sexual function in psoriasis patients and investigate the roles of anxiety, depression and psoriasis' distribution patterns in sexual dysfunction. METHODS: A comparative study matched for sex and age was performed. Eighty patients with moderate to severe psoriasis and 80 healthy controls were included. The participants completed the Massachusetts General Hospital-Sexual Functioning Questionnaire, the Hospital Anxiety and Depression Scale, and the Self-Administered Psoriasis Area and Severity Index. RESULTS: Psoriasis was associated with sexual dysfunction, odds ratio=5.5 (CI 95% 2.6-11.3; p<0.001). Certain distribution patterns of psoriasis, involving specific body regions, were associated with an increase in sexual dysfunction in the group presenting the disease, odds ratio 7.9 (CI 95% 2.3-33.4; p<0.001). Multivariate logistic regression analysis identified anxiety and depression, and the involvement of these specific areas, as possible independent risk factors for sexual dysfunction in patients with moderate to severe psoriasis. CONCLUSION: This study identifies body areas potentially related to sexual dysfunction, independently of anxiety and depression, in psoriasis patients. The results suggest that the assessment of sexual dysfunction and the involvement of these body areas should be considered as disease severity criteria when choosing the treatment for psoriasis patients

Influencia del Patrón de Dieta Mediterráneo sobre la superficie ocular

El síndrome de ojo seco es una enfermedad multifactorial de la superficie ocular que se caracteriza por la pérdida de homeostasis de la película lagrimal, en los que la hiperosmolaridad, la inestabilidad de la película lagrimal, la inflamación, el daño de la superficie ocular y las anomalías neurosensoriales desempeñan papeles fisiopatológicos fundamentales. Su prevalencia aumenta con la edad y se ha asociado a distintas condiciones como sexo, raza, disfunción de glándulas de Meibomio, conectivopatías y síndrome metabólico. También se ha asociado a un déficit o una ratio anormal entre los ácidos grasos poliinsaturados omega-3 y omega-6. Por ello, se ha empleado el uso de suplementos alimenticios de omega-3 y omega-6 como parte del tratamiento. Estos ácidos grasos poli-insaturados se pueden encontrar en abundancia y en la proporción adecuada en una dieta mediterránea tradicional, asociada a una reducción del estado proinflamatorio del organismo y en particular a la mejora de la salud cardiovascular. El objetivo de esta tesis es investigar el efecto de los suplementos alimenticios y la dieta sobre los parámetros de función lagrimal. Para analizar la evidencia científica que avala el uso de suplementos orales de omega- 3 y omega-6 para el tratamiento del ojo seco se ha realizado una revisión sistemática y meta-análisis de ensayos clínicos aleatorizados. Posteriormente se realizó un estudio de la modificación de los parámetros de función lagrimal en pacientes incluidos en el estudio PREDIMED-PLUS. En él se evalúa el efecto de una intervención intensiva con objetivos de pérdida de peso, basada en el consumo de dieta mediterránea hipocalórica, promoción de actividad física y terapia conductual en la prevención de enfermedades cardiovasculares. Para ello se ofertó la participación en el estudio a los sujetos que se reclutaron para el estudio mencionado a partir de enero de 2016. Tras la aleatorización, aquellos que aceptaron someterse a una revisión oftalmológica adicional al protocolo de estudio fueron evaluados de forma basal y tras 6 meses de participación en el estudio. Los test empleados fueron: encuestas relativas a sintomatología, tiempo de ruptura lagrimal, test de Schirmer y tinción corneal. Los resultados de la revisión sistemática muestran que la suplementación oral con omega-3 y omega-6 mejora los síntomas de ojo seco, la estabilidad de la película lagrimal y la producción de lágrima. Según la evidencia actual disponible, se puede recomendar la suplementación con omega-3 en la práctica clínica para el tratamiento de esta afección. La implementación de un patrón de dieta mediterráneo durante 6 meses produjo una mejora en los parámetros de función lagrimal relacionados con el ojo seco obteniendo una disminución significativa en la puntuación de las escalas de síntomas DEES -0,35 ± 0,15 (p 0,025) y OSDI -1,75 ± 0,9 (p 0,039). La estabilidad lagrimal aumentó de media 0,67 ± 0,15 segundos (p <0,001) tras el periodo de estudio. El aumento medio de la prueba de Schirmer desde el inicio fue de 0,5 ± 0,14 mm (p <0,001). La tinción de la superficie ocular, aplicando la escala de gradación de Oxford, mostró una disminución de 0,10 ± 0,04 puntos (p <0,01). Estas diferencias fueron mayores en el grupo de intervención intensiva. En conclusión podemos recomendar como beneficioso para los sujetos afectos de síndrome de ojo seco tanto la suplementación oral con ácidos grasos omega-3 y omega-6 como un estilo de vida con actividad física moderada y una alimentación basada en una dieta mediterránea tradicional.Tesis Univ. Granada

Efficacy of nutritional supplementation with omega-3 and omega-6 fatty acids in dry eye syndrome: a systematic review of randomized clinical trials.

To critically appraise scientific evidence regarding the efficacy of nutritional supplementation with omega-3 and omega-6 fatty acids for the treatment of dry eye syndrome (DES). A systematic review of randomized clinical trials was performed. Two independent reviewers selected and analysed the scientific papers that met inclusion and exclusion criteria. Objective and subjective efficacy outcomes were assessed. The trials involved a total of 2591 patients in fifteen independent studies. All studies were published between 2005 and 2015. The supplements used were mostly omega-3 and omega-6 in different proportions. Subjective improvement was measured using mainly Ocular Surface Disease Index (OSDI) test and Dry Eye Severity Score (DESS) test: significant differences in favour of the experimental group were found in seven of the studies. The objective amelioration was assessed by lacrimal function parameters: Tear break-up time (TBUT) significantly increased in nine studies and Schirmer's test in four studies. We observed a discrete improvement in the parameters of tear function. Scientific evidence is not strong enough to systematically recommend the use of omega-3 and omega-6 fatty acids as a standalone treatment of DES independently from its aetiology. However, they could be considered as an effective alternative to topical treatment in patients with DES secondary to certain pathologies

BJS commission on surgery and perioperative care post-COVID-19

Background: Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues experiences and published evidence. Methods: In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them. Results: BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training. Conclusion: The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era

BJS commission on surgery and perioperative care post-COVID-19

Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues' experiences and published evidence