Dietary fiber and glucose tolerance in Japanese Brazilians

Univ São Paulo, Dept Nutr, Sch Publ Hlth, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Prevent Med, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Prevent Med, São Paulo, BrazilWeb of Scienc

Dietary fat is associated with metabolic syndrome in Japanese Brazilians

OBJECTIVE - the aim of this study was to examine the association of nutrient intakes with metabolic syndrome in a Japanese descendant population at high risk for metabolic abnormalities.RESEARCH DESIGN and METHODS - in a population-based study of Japanese Brazilians aged :30 years, 412 men and 465 women were studied. the diagnosis of metabolic syndrome was based on the National Cholesterol Education Program criteria modified for Asians. Food intake was assessed by a validated food frequency questionnaire.RESULTS - Men and women showed similar mean ages (55.7 +/- 12.7 and 54.4 +/- 11.9 years) and 49% (95% Cl 44.8-54.6) and 43% (38.4-47.6) had metabolic syndrome, respectively, As expected, clinical parameters were less favorable in the subset of subjects with metabolic syndrome. Men with metabolic syndrome showed higher cholesterol (233.2 +/- 116.3 vs. 211.7 +/- 5.8 g/day, P < 0.05) and lower carbohydrate (288.5 +/- 45.8 vs. 300.1 +/- 39.8 g/day, P < 0.001) intakes than those Without metabolic syndrome, but no difference was observed among the women. After adjusting for sex, age, smoking, education level, generation, physical activity, total energy, and dietary fiber intake, a positive association between Metabolic syndrome and total fat intake was detected. Comparing people in the highest quintile of total fat consumption with those in the lowest quintile, odds ratio (OR) of metabolic syndrome was 5.0 ([95% Cl 1.58-16.00] P < 0.005). in contrast, linoleic acid intake was inversely associated with metabolic syndrome (OR 0.50 [95% Cl 0.26-0.981 P < 0.05). Considering food groups, after adjustments only fried food intake was shown to be associated with increased risk of metabolic syndrome.CONCLUSIONS- Despite the limitation of such a study design in investigating cause-effect relationships, our findings favor the hypothesis that dietary total fat may increase whereas linoleic acid intake may reduce the risk of metabolic syndrome in Japanese descendants living in Brazil.Universidade Federal de São Paulo, Dept Prevent Med, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Internal Med, Div Endocrinol, BR-04023062 São Paulo, BrazilUniv São Paulo, Sch Publ Hlth, Dept Nutr, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Prevent Med, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Internal Med, Div Endocrinol, BR-04023062 São Paulo, BrazilWeb of Scienc

Optimising intravenous salbutamol in children: a phase 2 study

OBJECTIVE: The β2-agonists such as salbutamol are the mainstay of asthma management. Pharmacokinetic-pharmacodynamic (PKPD) models to guide paediatric dosing are lacking. We explored the relationship between salbutamol dose, serum concentration, effectiveness and adverse effects in children by developing a PKPD model. DESIGN: A prospective cohort study of children admitted to hospital with acute asthma, who received intravenous salbutamol. SETTING: Children were recruited in two cohorts: the emergency departments of two London hospitals or those retrieved by the Children's Acute Transport Service to three London paediatric intensive care units. PATIENTS: Patients were eligible if aged 1-15 years, admitted for acute asthma and about to receive or receiving intravenous salbutamol. INTERVENTIONS: Treatment was according to local policy. Serial salbutamol plasma levels were taken. Effectiveness measurements were recorded using the Paediatric Asthma Severity Score (PASS). Toxicity measurements included lactate, pH, glucose, heart rate, blood pressure and arrhythmias. PKPD modelling was performed with non-linear mixed-effect models. MAIN OUTCOMES: Fifty-eight children were recruited with 221 salbutamol concentration measurements from 54 children. Median (range) age was 2.9 (1.1-15.2) years, and weight was 13.6 (8-57.3) kg. Ninety-five PASS measurements and 2078 toxicity measurements were obtained. RESULTS: A two-compartment PK model adequately described the time course of salbutamol-plasma concentrations. An EMAX (maximum drug effect) concentration-effect relationship described PASS and toxicity measures. PKPD simulations showed an infusion of 0.5 µg/kg/min (maximum 20 µg/min) for 4 hours after bolus achieves >90% maximal bronchodilation for 12 hours. CONCLUSIONS: A paediatric PKPD model for salbutamol is described. An infusion of 0.5 µg/kg/min after bolus achieves effective bronchodilation. Higher rates are associated with greater tachycardia and hyperglycaemia

Reward-related gustatory and psychometric predictors of weight loss following bariatric surgery: a multicenter cohort study

© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact [email protected]: Reward sensitivity has been proposed as a potential mediator of outcomes for bariatric surgery. Objectives: We aimed to determine whether gustatory and psychometric measures of reward-related feeding are predictors of bariatric-induced weight loss. Methods: A multicenter longitudinal cohort study was conducted in patients scheduled for bariatric surgery (surgical group), assessed at baseline and 2 follow-up assessments. Predictions of % weight loss from baseline (%WL) according to baseline gustatory measures, including intensity and pleasantness ratings of sweet and other tastants, and psychometric measures of reward-related feeding behavior, including hedonic hunger scores, were assessed with multivariable linear regression. Exploratory analyses were conducted to test for associations between %WL and changes in gustatory and psychophysical measures, as well as for comparisons with data from patients on the surgery waiting list (control group). Results: We included 212 patients, of whom 96 in the surgical group and 50 in the control group were prospectively assessed. The groups were similar at baseline and, as expected, bariatric surgery resulted in higher %WL (BTreatment-Time = 2.4; 95% CI: 2.1-2.8; P < 0.0001). While variation in gustatory measures did not differ between groups, in the surgery group baseline sweet intensity predicted %WL at the primary endpoint (11 to 18 months postoperatively; β = 0.2; B = 0.2, 95% CI: 0.02 to 0.3; P = 0.02), as did hedonic hunger scores (β = -0.2; B = -2.0, 95% CI: -3.8 to -0.3; P = 0.02). Furthermore, at this endpoint, postsurgical reduction of sweet taste intensity and acceptance of sweet foods were associated with %WL (β = -0.3; B = -3.5, 95% CI: -5.8 to -1.3; P = 0.003, and β = -0.2; B = -4.7, 95% CI: -8.5 to -0.8; P = 0.02, respectively). The use of sweet intensity as a predictor of weight change was confirmed in another bariatric cohort. Conclusions: Sweet intensity ratings and hedonic hunger scores predict %WL after surgery. The variability of sweet intensity ratings is also associated with %WL, further suggesting they may reflect physiological processes that are variably modulated by bariatric surgery, influencing clinical outcomes.AJO-M is a recipient of a grant from Schuhfried GmBH for norming and validation of cognitive tests; is national coordinator for Portugal of a non-interventional study (EDMS-ERI-143085581, 4.0) to characterize a treatment-resistant depression cohort in Europe, sponsored by Janssen-Cilag Ltd; and is national coordinator of a trial of psilocybin therapy for treatment-resistant depression, sponsored by Compass Pathways, Ltd (EudraCT NUMBER: 2017–003288–36).info:eu-repo/semantics/publishedVersio

Effect of recreational beach tennis on ambulatory blood pressure and physical fitness in hypertensive individuals (BAH study) : rationale and study protocol

Background: Different physical activities are widely recommended as non-pharmacological therapies to reduce blood pressure. However, the effectiveness of exercise programs is associated with its continuity and regularity, and the long-term adherence to traditional exercise interventions is often low. Recreational sports emerge as an alternative, being more captivating and able to retain individuals for longer periods. Besides, sport interventions have demonstrated improvements in physical fitness components that are associated with a lower incidence of hypertension. However, no studies have investigated the effects of recreational sports on 24 h ambulatory blood pressure. The aim of the present study is to evaluate the effect of beach tennis training on ambulatory blood pressure and physical fitness in individuals with hypertension. Methods: This study will be a randomized, single-blinded, two-arm, parallel, and superiority trial. Forty-two participants aged 35–65 years with previous diagnosis of hypertension will be randomized to 12 weeks of beach tennis training group (two sessions per week lasting 45–60 min) or a non-exercising control group. Ambulatory (primary outcome) and office blood pressures, cardiorespiratory fitness, muscle strength/power and quality of life will be assessed at baseline and after the intervention period. Discussion: Our conceptual hypothesis is that beach tennis training will reduce ambulatory blood pressure and improve fitness parameters in middle-aged individuals with hypertension. The results of this trial are expected to provide evidences of efficacy of recreational beach tennis practice on blood pressure management and to support sport recommendations for clinical scenario in higher risk populations

Integrated chromosomal and plasmid sequence analyses reveal diverse modes of carbapenemase gene spread among Klebsiella pneumoniae.

Molecular and genomic surveillance systems for bacterial pathogens currently rely on tracking clonally evolving lineages. By contrast, plasmids are usually excluded or analyzed with low-resolution techniques, despite being the primary vectors of antibiotic resistance genes across many key pathogens. Here, we used a combination of long- and short-read sequence data of Klebsiella pneumoniae isolates (n = 1,717) from a European survey to perform an integrated, continent-wide study of chromosomal and plasmid diversity. This revealed three contrasting modes of dissemination used by carbapenemase genes, which confer resistance to last-line carbapenems. First, blaOXA-48-like genes have spread primarily via the single epidemic pOXA-48-like plasmid, which emerged recently in clinical settings and spread rapidly to numerous lineages. Second, blaVIM and blaNDM genes have spread via transient associations of many diverse plasmids with numerous lineages. Third, blaKPC genes have transmitted predominantly by stable association with one successful clonal lineage (ST258/512) yet have been mobilized among diverse plasmids within this lineage. We show that these plasmids, which include pKpQIL-like and IncX3 plasmids, have a long association (and are coevolving) with the lineage, although frequent recombination and rearrangement events between them have led to a complex array of mosaic plasmids carrying blaKPC Taken altogether, these results reveal the diverse trajectories of antibiotic resistance genes in clinical settings, summarized as using one plasmid/multiple lineages, multiple plasmids/multiple lineages, and multiple plasmids/one lineage. Our study provides a framework for the much needed incorporation of plasmid data into genomic surveillance systems, an essential step toward a more comprehensive understanding of resistance spread

Mobilisation of Hematopoietic CD34+ Precursor Cells in Patients with Acute Stroke Is Safe - Results of an Open-Labeled Non Randomized Phase I/II Trial

German Clinical Trial Register DRKS 00000723

Revisiting clinical trials on glycemic control and cardiovascular risk

The most relevant clinical trials, assessing the role of glycemic control in reducing cardiovascular risk, are examined. The UKPDS was the first to address this issue. More recent trials (ACCORD, ADVANCE and VADT) are controversial and evidences did not support that strict glycemic control (reflected by normal glycated hemoglobin) exclusively is sufficient to reduce cardiovascular risk in complicated individuals with long-term type 2 diabetes mellitus. Some possible reasons for controversies are included