Einfluss einer Vitamin D-Supplementierung auf kardiovaskuläre Risikomarker bei Übergewichtigen und Adipösen während einer telemedizinisch betreuten Gewichtsreduktion

Die Prävalenz einer Hypovitaminose D bei übergewichtigen und adipösen Personen ist hoch. Niedrige Blutkonzentrationen an den Vitamin D-Metaboliten 25-Hydroxyvitamin D (25(OH)D) und Calcitriol (1,25(OH)2D) sowie hohe Konzentrationen an Parathormon (PTH) werden als neue Risikomarker kardiovaskulärer Erkrankungen betrachtet. Im Adipocyten steigert Calcitriol jedoch die Lipogenese und vermindert die Lipolyse, was eine Gewichtsreduktion behindern könnte. In der vorliegenden Studie wurde der Einfluss einer Vitamin D-Supplementierung auf kardiovaskuläre Risikomarker und die Gewichtsabnahme bei Übergewichtigen und Adipösen während der Teilnahme an einem telemedizinisch betreuten Gewichtsreduktionsprogramm untersucht. 200 übergewichtige und adipöse Teilnehmer mit mittleren 25(OH)D-Konzentrationen von 30 nmol/l erhielten über einen Zeitraum von zwölf Monaten während der Teilnahme an einem Gewichtsreduktionsprogramm randomisiert, doppelblind, täglich 83 µg (3320 IE) Vitamin D3 oder ein Placebopräparat. Alle Teilnehmer wurden telemedizinisch betreut (Übermittlung des Körpergewichts via Bluetooth®-Technik und telefonische Ernährungsberatung). Anthropometrische und klinische Daten wurden zu Beginn sowie nach sechs und zwölf Monaten erfasst; biochemische Parameter zu Beginn und nach zwölf Monaten. Die Energieaufnahme, der Energieumsatz und die Nährstoffaufnahme wurden zu Beginn, in den ersten sechs Monaten monatlich sowie nach zwölf Monaten geschätzt. Die mittlere Gewichtsreduktion nach zwölf Monaten wurde durch die Vitamin D- oder Placeboeinnahme nicht beeinflusst (-5,7 kg bzw. -6,4 kg, p = 0,191). Die mittleren 25(OH)D- und Calcitriolkonzentrationen stiegen um 55,5 nmol/l bzw. 40,0 pmol/l in der Vitamin D-Gruppe, in der Placebogruppe hingegen lediglich um 11,8 nmol/l bzw. 9,3 pmol/l (beides p Impact of vitamin D supplementation on cardiovascular disease risk markers in overweight and obese subjects while participating in a telemedically-guided weight loss programPrevalence of hypovitaminosis D in overweight and obese subjects is high. Low blood concentrations of the vitamin D metabolites 25-hydroxyvitamin D (25(OH)D) and calcitriol (1,25(OH)2D) as well as high concentrations of parathyroid hormone (PTH) are considered new cardiovascular disease risk markers. However, calcitriol increases lipogenesis and decreases lipolysis in adipocytes, which could restrain weight reduction. In the present study, effect of vitamin D supplementation on cardiovascular disease risk markers and weight loss in overweight and obese subjects while participating in a telemedically-guided weight reduction program was evaluated. 200 overweight and obese subjects with mean 25(OH)D concentrations of 30 nmol/l randomly received 83 µg (3320 IE) Vitamin D3 or placebo daily in a double-blind manner for twelve months while participating in a weight reduction program. All participants were telemedically supported (weight-transmission via Bluetooth®-technology and nutritional telephone consultation). At baseline, after six and twelve months, anthropometric and clinical data were assessed; biochemical parameter at baseline and after twelve months. At baseline, in the first six months monthly and after twelve months, energy intake, energy expenditure and nutrient intake were estimated. Mean weight loss was not affected by vitamin D supplementation or placebo (-5.7 kg and -6.4 kg, respectively, p = 0.191). However, mean 25(OH)D and calcitriol concentrations increased by 55.5 nmol/l and 40.0 pmol/l, respectively, in the vitamin D group but by only 11.8 nmol/l and 9.3 pmol/l, respectively, in the placebo group (both p < 0.001). Furthermore, the combination of vitamin D supplementation and weight loss resulted in a more pronounced decrease in the vitamin D group compared with the placebo group in blood concentrations of PTH (-26.5 % vs. -18.7 %; p = 0.014), triglycerides (-13.5 % vs. +3.0 %; p < 0.001), and tumor necrosis factor-α (-10.2 % vs. -3.2 %; p = 0.049), as well as a more pronounced increase of the blood concentration of low-density lipoprotein (+5.4 % vs. -2.4 %; p < 0.001). A daily vitamin D supplement of 83 µg does not adversely affect weight loss and improves cardiovascular disease risk markers in overweight and obese subjects

A randomized controlled trial on the efficacy of carbohydrate-reduced or fat-reduced diets in patients attending a telemedically guided weight loss program

<p>Abstract</p> <p>Background</p> <p>We investigated whether macronutrient composition of energy-restricted diets influences the efficacy of a telemedically guided weight loss program.</p> <p>Methods</p> <p>Two hundred overweight subjects were randomly assigned to a conventional low-fat diet and a low-carbohydrate diet group (target carbohydrate content: >55% energy and <40% energy, respectively). Both groups attended a weekly nutrition education program and dietary counselling by telephone, and had to transfer actual body weight data to our clinic weekly with added Bluetooth^®technology by mobile phone. Various fatness and fat distribution parameters, energy and macronutrient intake, and various biochemical risk markers were measured at baseline and after 6, and 12 months.</p> <p>Results</p> <p>In both groups, energy intake decreased by 400 kcal/d compared to baseline values within the first 6 months and slightly increased again within the second 6 months. Macronutrient composition differed significantly between the groups from the beginning to month 12. At study termination, weight loss was 5.8 kg (SD: 6.1 kg) in the low-carbohydrate group and 4.3 kg (SD: 5.1 kg) in the low-fat group (p = 0.065). In the low-carbohydrate group, triglyceride and HDL-cholesterol levels were lower at month 6 and waist circumference and systolic blood pressure were lower at month 12 compared with the low-fat group (P = 0.005–0.037). Other risk markers improved to a similar extent in both groups.</p> <p>Conclusion</p> <p>Despite favourable effects of both diets on weight loss, the carbohydrate-reduced diet was more beneficial with respect to cardiovascular risk factors compared to the fat-reduced diet. Nevertheless, compliance with a weight loss program appears to be even a more important factor for success in prevention and treatment of obesity than the composition of the diet.</p> <p>Trial registration</p> <p>Clinicaltrials.gov as NCT00868387</p

Proton beam therapy for pediatric tumors of the central nervous system — experiences of clinical outcome and feasibility from the KiProReg Study

Simple Summary Radiation therapy is an important cornerstone of the treatment of many different types of brain tumors occurring in childhood. Proton beam therapy offers the opportunity to reduce doses outside of the target volume due to its physical characteristics. By sparing a large volume of the brain from radiation doses, proton beam therapy aims at reducing long-term side effects and preserving cognitive function. Our study aims at better understanding side effects and therefore contributing to better treatment decisions in this vulnerable group of patients. Therefore, the study analyses outcome and side effects including imaging changes in a large cohort of children with brain tumors from a prospective registry. Abstract As radiotherapy is an important part of the treatment in a variety of pediatric tumors of the central nervous system (CNS), proton beam therapy (PBT) plays an evolving role due to its potential benefits attributable to the unique dose distribution, with the possibility to deliver high doses to the target volume while sparing surrounding tissue. Children receiving PBT for an intracranial tumor between August 2013 and October 2017 were enrolled in the prospective registry study KiProReg. Patient’s clinical data including treatment, outcome, and follow-up were analyzed using descriptive statistics, Kaplan–Meier, and Cox regression analysis. Adverse events were scored according to the Common Terminology Criteria for Adverse Events (CTCAE) 4.0 before, during, and after PBT. Written reports of follow-up imaging were screened for newly emerged evidence of imaging changes, according to a list of predefined keywords for the first 14 months after PBT. Two hundred and ninety-four patients were enrolled in this study. The 3-year overall survival of the whole cohort was 82.7%, 3-year progression-free survival was 67.3%, and 3-year local control was 79.5%. Seventeen patients developed grade 3 adverse events of the CNS during long-term follow-up (new adverse event n = 7; deterioration n = 10). Two patients developed vision loss (CTCAE 4°). This analysis demonstrates good general outcomes after PBT

Radiation therapy plays an important role in the treatment of atypical teratoid/rhabdoid tumors: analysis of the EU-RHAB cohorts and their precursors

Purpose Atypical teratoid/rhabdoid tumor (AT/RT) is a rare malignancy of the central nervous system in young children with a dismal prognosis. Prognostic markers have been extensively investigated but have not been validated. The role of radiation therapy (RT) remains controversial. We evaluated the impact of RT as part of multimodality treatment by analyzing data of a European AT/RT cohort. Methods and Materials We retrospectively analyzed data of the European Registry for Rhabdoid Tumors and its precursors. Primary endpoints were progression-free survival (PFS) and overall survival (OS). Potential impact of prognostic factors was analyzed using univariable and multivariable Cox regression analyses with RT as a time-dependent factor. Results Data of 186 children (118 male, 68 female) treated from 1990 to 2016 were evaluable. The median age at diagnosis was 1.57 years (range, 0.01-26.70 years); 47% (87/186) of the patients were under the age of 18 months. Sixty-nine percent (128/186) received RT (focal RT, n = 93; craniospinal treatment with local boost, n = 34; spinal irradiation, n = 1). The median follow-up duration of the entire cohort was 1.73 years (range, 0.06-20.11 years). The estimated PFS and OS rates were 48% (95% CI, 41%-55%) and 72% (95% CI, 65%-78%) at 1 year and 33% (95% CI, 26%-40%) and 49% (95% CI, 41%-56%) at 2 years, respectively. On multivariable analysis, RT was an independent significant prognostic factor for PFS (hazard ratio, 0.45; 95% CI, 0.27-0.75; P = .002) and OS (hazard ratio, 0.54; 95% CI, 0.32-0.93; P = .025). Conclusions This analysis confirms the relevance of local therapies. RT was an independent prognostic factor for outcomes in children experiencing AT/RT. However, long-term sequelae have to be carefully evaluated and considered given the young age at time of RT

Tetra(peri‐naphthylene)anthracene: A Near‐IR Fluorophore with Four‐Stage Amphoteric Redox Properties

Abstract A novel, benign synthetic strategy towards soluble tetra(peri‐naphthylene)anthracene (TPNA) decorated with triisopropylsilylethynyl substituents has been established. The compound is perfectly stable under ambient conditions in air and features intense and strongly bathochromically shifted UV/vis absorption and emission bands reaching to near‐IR region beyond 900 nm. Cyclic voltammetry measurements revealed four facilitated reversible redox events comprising two oxidations and two reductions. These remarkable experimental findings were corroborated by theoretical studies to identify the TPNA platform a particularly useful candidate for the development of functional near‐IR fluorophores upon appropriate functionalization

Fractionation of an Extract of Pluchea odorata Separates a Property Indicative for the Induction of Cell Plasticity from One That Inhibits a Neoplastic Phenotype

Introduction. Several studies demonstrated that anti-inflammatory remedies exhibit excellent anti-neoplastic properties. An extract of Pluchea odorata (Asteraceae), which is used for wound healing and against inflammatory conditions, was fractionated and properties correlating to anti-neoplastic and wound healing effects were separated. Methods. Up to six fractionation steps using silica gel, Sephadex columns, and distinct solvent systems were used, and eluted fractions were analysed by thin layer chromatography, apoptosis, and proliferation assays. The expression of oncogenes and proteins regulating cell migration was investigated by immunoblotting after treating HL60 cells with the most active fractions. Results. Sequential fractionations enriched anti-neoplastic activities which suppressed oncogene expression of JunB, c-Jun, c-Myc, and Stat3. Furthermore, a fraction (F4.6.3) inducing or keeping up expression of the mobility markers MYPT, ROCK1, and paxillin could be separated from another fraction (F4.3.7), which inhibited these markers. Conclusions. Wound healing builds up scar or specific tissue, and hence, compounds enhancing cell migration support this process. In contrast, successful anti-neoplastic therapy combats tumour progression, and thus, suppression of cell migration is mandatory

Crucial role of ultraviolet light for desert ants in determining direction from the terrestrial panorama

Ants use the panoramic skyline in part to determine a direction of travel. A theoretically elegant way to define where terrestrial objects meet the sky is to use an opponent-process channel contrasting green wavelengths of light with ultraviolet (UV) wavelengths. Compared with the sky, terrestrial objects reflect relatively more green wavelengths. Using such an opponent-process channel gains constancy in the face of changes in overall illumination level. We tested the use of UV wavelengths in desert ants by using a plastic that filtered out most of the energy below 400 nm. Ants, Melophorus bagoti, were trained to home with an artificial skyline provided by an arena (experiment 1) or with the natural panorama (experiment 2). On a test, a homing ant was captured just before she entered her nest, and then brought back to a replicate arena (experiment 1) or the starting point (the feeder, experiment 2) and released. Blocking UV light led to deteriorations in orientation in both experiments. When the artificial skyline was changed from opaque to transparent UV-blocking plastic (experiment 3) on the other hand, the ants were still oriented. We conclude that UV wavelengths play a crucial role in determining direction based on the terrestrial surround.10 page(s

Learning new sensorimotor contingencies:Effects of long-term use of sensory augmentation on the brain and conscious perception

Theories of embodied cognition propose that perception is shaped by sensory stimuli and by the actions of the organism. Following sensorimotor contingency theory, the mastery of lawful relations between own behavior and resulting changes in sensory signals, called sensorimotor contingencies, is constitutive of conscious perception. Sensorimotor contingency theory predicts that, after training, knowledge relating to new sensorimotor contingencies develops, leading to changes in the activation of sensorimotor systems, and concomitant changes in perception. In the present study, we spell out this hypothesis in detail and investigate whether it is possible to learn new sensorimotor contingencies by sensory augmentation. Specifically, we designed an fMRI compatible sensory augmentation device, the feelSpace belt, which gives orientation information about the direction of magnetic north via vibrotactile stimulation on the waist of participants. In a longitudinal study, participants trained with this belt for seven weeks in natural environment. Our EEG results indicate that training with the belt leads to changes in sleep architecture early in the training phase, compatible with the consolidation of procedural learning as well as increased sensorimotor processing and motor programming. The fMRI results suggest that training entails activity in sensory as well as higher motor centers and brain areas known to be involved in navigation. These neural changes are accompanied with changes in how space and the belt signal are perceived, as well as with increased trust in navigational ability. Thus, our data on physiological processes and subjective experiences are compatible with the hypothesis that new sensorimotor contingencies can be acquired using sensory augmentation