A comparison of the quality of image acquisition between the incident dark field and sidestream dark field video-microscopes

BACKGROUND: The 'Cytocam' is a third generation video-microscope, which enables real time visualisation of the in vivo microcirculation. Based upon the principle of incident dark field (IDF) illumination, this hand held computer-controlled device was designed to address the technical limitations of its predecessors, orthogonal polarization spectroscopy and sidestream dark field (SDF) imaging. In this manuscript, we aimed to compare the quality of sublingual microcirculatory image acquisition between the IDF and SDF devices. METHODS: Using the microcirculatory image quality scoring (MIQS) system, (six categories scored as either 0 = optimal, 1 = acceptable, or 10 = unacceptable), two independent raters compared 30 films acquired using the Cytocam IDF video-microscope, to an equal number obtained with an SDF device. Blinded to the origin of the films, the raters were therefore able to score between 0 and 60 for each film analysed. The scores' distributions between the two techniques were compared. RESULTS: The median MIQS (95 % CI) given to the SDF camera was 7 (1.5-12), as compared to 1 (0.5-1.0) for the IDF device (p < 0.0001). Of the six categories assessed by the MIQS, nearly one fifth of the SDF videos were scored as unacceptable for pressure (20 %), content (20 %), and stability (17 %), with focus scoring deficiently 13 % of the time. High agreement between the two raters scoring values was evident, with an intra-class correlation coefficient (ICC) of 0.96 (95 % CI: 0.94, 0.98). CONCLUSIONS: These results demonstrate that the quality of sublingual microcirculatory image acquisition is superior in the Cytocam IDF video-microscope, as compared to the SDF video-microscope

The Impact of Demographic Characteristics and Lifestyle in the Distribution of Cystatin C Values in a Healthy Greek Adult Population

Background. The aim of the present study was to examine sources of variation for serum cystatin C in a healthy Greek population. Methods. Cystatin C together with basic clinical chemistry tests was measured in a total of 490 adults (46 ± 16 yrs, 40% males) who underwent an annual health check. Demographic, anthropometric, and lifestyle characteristics were recorded. Results. Higher values of cystatin C were observed among males (P = .04), participants aged over 65 years (P < .001), current smokers (P = .001) and overweight/obese participants (P = .03). On the contrary, alcohol consumption and physical activity seemed to have no influence on cystatin C levels (P = .61; P = .95, resp.). Conclusions. In interpreting serum cystatin C values in a healthy adult population, age, gender, Body Mass Index, and cigarette smoking need to be considered, and determination of reference ranges among distinct subpopulations seem to be prudent

Dietary meat fats and burden of cardiovascular disease risk factors, in the elderly: a report from the MEDIS study

Dietary fats have long been associated with human health, and especially cardiovascular disease (CVD). Some observational studies have shown that reduction in dietary fats, and particularly cholesterol is associated with lower cardiovascular risk; however, other prospective studies or randomized controlled trials of dietary fat reduction or modification have shown varying results on CVD morbidity and mortality. In this work we evaluated the relationships between dietary fats and a cluster of CVD risk factors (i.e., diabetes, obesity, hypercholesterolemia, hypertension), among elderly individuals without known CVD. In particular, dietary and clinical data from 1486 elderly (aged 65 to 100 years) men and women living in Cyprus, Mitilini, Samothraki, Cephalonia, Crete, Lemnos, Syros, Naxos, Corfu and Zakynthos islands, and participated in the MEDIS study, were analysed. Data analysis revealed that 18.5% of males and 33.3% of females had three or four cardiovascular disease risk factors; the major source of fat was olive oil (mean intake for men and women 50.0 ± 19.3 g/day and 46.0 ± 16.8 g/day, p < 0.001). In addition it was observed that a 5% increase in energy adjusted fat intake from meat was associated with a 21% increase in the likelihood of having one additional CVD risk factor (95%CI 6%-39%); no significant associations were observed regarding the other types of fat consumed by the elderly participants. These findings may state a hypothesis that the consumption of fat only from meat or its products seems to increase the burden of CVD risk factors among CVD-free, elderly people

Repeatability of food frequency assessment tools in relation to the number of items and response categories included

Background: Accuracy of a measurement is a cornerstone in research in order to make robust conclusions about the research hypothesis. Objective: To examine whether the number of items (questions) and the number of responses of consumption included in nutritional assessment tools influence their repeatability. Methods: During 2009, 400 participants (250 from Greece, 37±13 yrs, 34% males and 150 participants from Spain, 39±17 yrs, 41% males) completed a diet index with 11-items and binary (yes/no) responses, a diet-index with 11-items and 6-scale responses, a 36-item and a 76-item food frequency questionnaire (FFQ) with 6-scale responses. Participants completed these tools, twice, within 15-days period. Spearman-Brown (rsb), Kendall’s tau coefficients and the Bland-Altman method were applied to answer the research hypothesis. Results: The highest repeatability coefficient was observed for the 11-items with binary responses index (rsb=0.948, p<0.001), followed by the 11-items with 6-scale responses index (rsb=0.943, p<0.001), the 36-item (rsb=0.936, p<0.001) and the 76-item FFQs (rsb=0.878, p<0.001). Statistical comparisons revealed no significant differences between repeatability coefficients of the first three tools (p>0.23); whereas the aforementioned tools had significantly higher repeatability coefficients as compared with the 76-item FFQ (p=0.002). Sub-group analyses by gender, education, smoking and clinical status, confirmed the aforementioned results. Conclusion: Repeatability has been revealed for all food frequency assessment tools used, irrespective of the number of items or the number of responses included

Is parental longevity associated with the cardiovascular risk and the successful aging of their offspring? Results from the multinational MEDIS study

The aim of the present study was to evaluate the role of parental longevity and parental cardiovascular disease (CVD) history in CVD risk and successful aging of a random sample of older adults living in the Mediterranean basin and who participated in the MEDiterranean Islands (MEDIS) study. During 2005 to 2011, 2663 elders were voluntarily enrolled. A multidimensional successful aging index consisting of 10 components was used. Paternal and maternal longevity was defined as those older participants of whom both parents lived above the age of 90. The burden of CVD-related factors (CVD-RFs) was calculated as the total score of 4 major CVD-RFs (range 0-4). After adjustment, parental longevity was inversely associated with the burden of CVD-RFs ( P = .04). Moreover, parental longevity was positively associated with the older adults' successful aging score (β-coefficient [95% confidence interval]: .38 [0.06-0.71]). Parent's long living was revealed as an important factor for successful aging and for reduced CVD risk, suggesting that further research is needed in the genetic predisposition of longevity

Influence of Protein Intake from Haem and Non-haem Animals and Plant Origin on Inflammatory Biomarkers among Apparently-healthy Adults in Greece

Intake of different types of protein may be associated with differences in biomarkers among various populations. This work investigated the influence of protein intake from haem and non-haem animals as well as protein from plants on haematological and biochemical parameters in inflammation among apparentlyhealthy adults living in Greece, a Mediterranean country. Four hundred and ninety apparently-healthy subjects (46\ub116 years, 40% men), who consecutively visited Polykliniki General Hospital for routine examinations, voluntarily agreed to participate in the study (participation rate 85%). Demographic, anthropometric and lifestyle characteristics were recorded. Participants completed a valid, semi-quantitative food frequency questionnaire. Protein intake was classified into three sources: protein from haem animals, protein from non-haem animals, and protein from plant origin. Fasting blood samples were taken from all participants; uric acid, creatinine, lipids, cystatin C, haptoglobin, haemoglobin, haematocrit, iron, ferritin, white blood cells, monocytes, platelets, and C-reactive protein were measured. Protein intake from only haem animals was associated with increased haemoglobin and haematocrit levels (p&lt;0.05) whereas intake of protein from non-haem animals and plant origin was not associated with the investigated haematological and biochemical markers of low-grade chronic inflammation when lifestyle factors and overall dietary habits were taken into account. Intake of protein from only haem animals seems to be consistently associated with haematological markers. The confounding role of dietary habits and lifestyle variables on the tested parameters deserves further attention in future research

Effects of dietary nitrate supplementation on symptoms of acute mountain sickness and basic physiological responses in a group of male adolescents during ascent to Mount Everest Base Camp

The purpose of this study was to investigate the effects of dietary nitrate supplementation, in the form of beetroot juice, on acute mountain sickness (AMS) symptoms and physiological responses, in a group of young males trekking to Mount Everest Base Camp (EBC). Forty healthy male students (mean age (SD): 16 (1) yrs) trekked to EBC over 11 days. Following an overnight fast, each morning participants completed the Lake Louise AMS questionnaire and underwent a series of physiological tests: resting blood pressure as well as resting and exercising heart rate, respiratory rate, and peripheral oxygen saturation. The exercise test consisted of a standardised 2-minute stepping protocol and measurements were taken in the last 10 seconds. Participants in the intervention arm of the study consumed 140 ml of concentrated beetroot juice daily, containing approximately 10 mmoles of nitrate, while those in the control arm consumed 140 ml of concentrated blackcurrant cordial with negligible nitrate content. Drinks were taken for the first seven days at high altitude (days 2 to 8), in two equal doses; one with breakfast, and one with the evening meal. Mixed modelling revealed no significant between-groups difference in the incidence of AMS (Odds Rationitrate vs. control: 1.16 (95% CI: 0.59; 2.29)). Physiological changes occurring during ascent to high altitude generally were not significantly different between the two groups (Model Coef (95% CI) – average difference nitrate vs. control: systolic blood pressure, 0.16 (-4.47; 4.79); peripheral oxygen saturation, 0.28 (-0.85; 1.41); heart rate, -0.48 (-8.47; 7.50) (Model Coef (95% CI) – relative difference nitrate vs. control: ventilatory rate, 0.95 (0.82; 1.08)). Modelling revealed that diastolic blood pressure was 3.37 mmHg (0.24; 6.49) higher for participants in the beetroot juice, however this difference was no larger than that found at baseline and no interaction effect was observed. Supplementation with dietary nitrate did not significantly change symptoms of AMS or alter key physiological variables, in a group of adolescent males during a high altitude trekking expedition. There was no evidence of harm from dietary nitrate supplementation in this context. Given the wide confidence intervals in all models, a larger sample size would be required to exclude a false negative result. Our data suggest that prolonged oral nitrate supplementation is safe and feasible at altitude but has little physiological or clinical effect