Polysacharide of Agaricus blazei gel mitigates bone necrosis in model of the jaws related to bisphosphonate via Wnt signaling

To investigate de effect of PAb gel on the bone tissue of rats submitted to Bisphosphonate-related osteonecrosis of the jaws (BRONJ). Initially, 54 animals were submitted to BRONJ model by Zoledronic Acid (ZA) (0.1 mg/kg 3x/wk for 9 wk, ip), followed by the 1st upper left molar extraction at the 8th wk. After tooth removal, the animals were divided into 3 groups, ZA that received placebo gel or PAb gel that received 1% PAb gel, inside the dental alveolus. The control Group (CONTROL) received 0.1 mg/kg of 0.9% saline and then placebo gel. Three weeks after tooth extraction, the animals were euthanized, and maxillae were colleted for macroscopic, radiographic, histological and Raman spectomery assays. Additionally, GSK3b, beta-catenin, and Runx2 mRNA expressions were determined. Blood samples were collected for the analysis of Bone-specific alkaline phosphatase (BALP) levels. PAb gel improved mucosal healing, increased the number of viable osteocytes, while it reduced the number of empty lacunae, as well as the amount of bone sequestration. Furthermore, PAb gel positively influenced the number and functionality of osteoblasts by stimulating Wnt signaling, thereby inducing bone remodeling. Additionally, PAb gel contributed to improved bone quality, as evidenced by an increase in bone mineral content, a decrease in bone solubility, and an enhancement in the quality of collagen, particularly type I collagen. PAb gel mitigated bone necrosis by stimulating of bone remodeling through Wnt signaling and concurrently improved bone quality. PAb gel emerges as a promising pharmacological tool for aiding in BRONJ therapy or potentially preventing the development of BRONJ.

Milk kefir therapy improves the skeletal response to resistance exercise in rats submitted to glucocorticoid-induced osteoporosis

Glucocorticoid-induced osteoporosis (GIO) has emerged as a challenge after long-term glucocorticoids (GCs) administration. Exercise has been an important non-pharmacological option, while medications modulate bone remodeling despite adverse effects. In this way, milk Kefir (MK) therapy stands out as a safe alternative to improve bone metabolism. Our study aimed to investigate the effect of MK associated to resistance exercise on bone loss in rats with GIO. For this, sixty male Wistar rats were divided into 2 groups: normal (N) and subjected to GIO, which was subdivided into 4 groups: control (C), milk kefir therapy (K), Exercise (Ex), and Exercise+K (ExK). GIO was induced by dexamethasone (7 mg/kg - i.m.; 1×/wk, 5 wk). MK was administered daily (1×/day; 0.7 ml/animal) and the climb exercise with load was performed 3×/wk; both for 16 wk. Femur was collected for assessment of bone microarchitecture, quality and metabolism. GIO markedly reduced trabecular bone volume density (BV/TV) (-35 %), trabecular thickness (Tb.Th) (-33 %), mineral content of femur (-26 %) as well as bone collagen content (-56 %). Bone strength and its biomechanical properties given by flexural strength (-81 %), fracture load (-80 %), and the number of osteocytes (-84 %) were lowered after GIO. GCs reduced osteoblast number and function while increased osteoclast number, altering bone remodeling (p < 0.05). On the other hand, ExK significantly improved bone microarchitecture and quality, marked by fractal dimension increase (+38 %), cortical volume (+34 %), BV/TV (+34 %), Tb.Th (+33 %), mineral content and collagen maturity, while reduced the space between trabecula (-34 %). The Ex and ExK increased the number of osteocytes (p < 0.05) and they were able to reverse the lower osteoblast number. Both treatments used alone significantly enhanced bone biomechanical properties, but the ExK showed a more significant improvement. ExK ameliorated bone strength and biomechanics (p < 0.05) and stimulated bone formation and modulated bone remodeling (p < 0.05). MK and exercise administered isolated or in association increased the percentage of collagen bone filling after GIO (p < 0.05), but only ExK improved collagen maturity. Our results showed that MK associated to resistance exercise enhanced bone microarchitecture, quality and metabolism, being therefore an interesting tool to improve skeletal response during GIO.

Improved microvascular reactivity after aged garlic extract intake is not mediated by hydrogen sulfide in older adults at risk for cardiovascular disease: a randomized clinical trial

PURPOSE

This study aimed to investigate the effects of AGE on microvascular reactivity, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in older individuals at high risk for cardiovascular disease (CVD). Urinary thiosulfate was also investigated as an indirect marker of endogenous hydrogen sulfide (H₂S) synthesis. The study was conducted in a randomized, double-blind, crossover, and placebo-controlled way.

METHODS

Twenty-eight participants (14 male), 67 ± 6 years old with CVD risk factors, ingested 2.4 g of AGE or placebo (PLA). Near-infrared spectroscopy evaluated tissue oxygen saturation (StO₂) during a vascular occlusion test (30 s baseline, 5 min occlusion, and 2 min reperfusion). The upslope of StO₂ signal after cuff release was calculated to measure microvascular reactivity. Urinary thiosulfate levels were measured using a high-performance liquid chromatography system.

RESULTS

The upslope of StO₂ was significantly faster after AGE (1.01 ± 0.37% s^-1) intake compared to PLA (0.83 ± 0.35% s^-1; P < 0.001; d = 0.50). Relative changes in Δ% SBP from pre- to post-AGE intake (- 5.17 ± 5.77%) was significantly different compared to Δ% PLA (0.32 ± 5.99%; P = 0.001; d = 0.93). No significant changes in urinary thiosulfate concentrations were observed between interventions. Moreover, no significant gender effect in any parameter assessed was found.

CONCLUSION

This study demonstrated that a single dose of AGE improved microvascular reactivity in older adults at risk of CVD despite such an effect was not linked with urinary thiosulfate levels. This trial was registered at clinicaltrials.gov as NCT04008693 (May 19, 2020).

Suitability of the muscle O2 resaturation parameters most used for assessing reactive hyperemia: a near-infrared spectroscopy study

Background

There is a spectrum of possibilities for analyzing muscle O₂ resaturation parameters for measurement of reactive hyperemia in microvasculature. However, there is no consensus with respect to the responsiveness of these O₂ resaturation parameters for assessing reactive hyperemia.

Objectives

This study investigates the responsiveness of the most utilized muscle O₂ resaturation parameters to assess reactive hyperemia in the microvasculature of a clinical group known to exhibit impairments of tissue O₂ saturation (StO₂).

Methods

Twenty-three healthy young adults, twenty-nine healthy older adults, and thirty-five older adults at risk of cardiovascular disease (CVD) were recruited. Near-infrared spectroscopy (NIRS) was used to assess StO₂ after a 5-min arterial occlusion challenge and the following parameters were analyzed: StO_{2slope_10s}, StO_{2slope_30s}, and StO_{2slope_until_baseline} (upslope of StO₂ over 10s and 30s and until StO₂ reaches the baseline value); time to StO_2baseline and time to StO_2max (time taken for StO₂ to reach baseline and peak values, respectively); ∆StO_2reperfusion (the difference between minimum and maximum StO₂ values); total area under the curve (StO_2AUCt); and AUC above the baseline value (StO_{2AUC_above_base}).

Results

Only StO_{2slope_10s} was significantly slower in older adults at risk for CVD compared to healthy young individuals (p < 0.001) and to healthy older adults (p < 0.001). Conversely, time to StO_2max was significantly longer in healthy young individuals than in older adult at CVD risk.

Conclusions

Our findings suggest that StO_{2slope_10s} may be a measure of reactive hyperemia, which provides clinical insight into microvascular function assessment.

Food safety in canteens: a public health programme in Aveiro region (Portugal) in 2018 and 2019

Background

Each year, 23 million people get ill from unsafe food in Europe. Food safety refers to the absence or safe acceptable levels of hazards in food that may harm the health of consumers. The Public Health Unit of Baixo Vouga Primary Healthcare Cluster (Aveiro region) developed a programme to identify hazards and promote implementation of corrective measures in community canteens that serve children and elderly. It has three fields of action: qualitative evaluation of the installation and operating conditions, based on the legislation; microbiological surveillance of food and utensils; training of food handlers and managers. This study aims to describe the results of such programme in 2018 and 2019.

Methods

This cross-sectional study used data from qualitative evaluation and microbiological results for a descriptive analysis. Additionally, an assess of the compliance of the critical points was performed to identify the main barriers in achieving the proposed targets.

Results

From a total of 420 registered canteens, 211 and 294 were evaluated in 2018 and 2019, respectively. For these years, only 87 (41.2%) and 124 (33.3%) fully complied with all critical points. The main problems were the lack of non-manual activation system in wash basins and faucets and inadequately instructed food handlers about required hygiene measures. Microbiological surveillance results of 371 and 393 samples had a proportion of satisfactory or acceptable results of: 93.5% and 91.3% for the main dish; 56.1% and 46.6% for the salads and 82.4% and 79.8% for the utensils. Coliform bacteria were the most common agent.

Conclusions

The compliances with critical points were low, accounting for the fact they are legislation-based. The microbiological results were worst for the salads' samples. Deviations give us hints of what should be reinforced. Education of the food handlers and consulting with companies to improve procedures and equipment could be of great use.

Key messages

Community canteens’ compliances with legislated criteria were low. This programme is useful in identifying vulnerabilities and may lead to the implementation of corrective measures.

Is flow-mediated dilatation associated with near-infrared spectroscopy-derived magnitude of muscle O2 desaturation in healthy young and individuals at risk for cardiovascular disease?

Vascular occlusion test (VOT)-induced reactive hyperemia in brachial artery is crucial to flow-mediated dilation (FMD). Emerging studies have suggested that reactive hyperemia depends on the magnitude of the O₂ desaturation (ischemia) in downstream microvessels. Although near-infrared spectroscopy-derived tissue O₂ saturation index (TSI) has been used to assess the magnitude of ischemia, the association between FMD and the magnitude of O₂ desaturation has not been addressed. Therefore, the aim of the present study was to evaluate whether FMD correlates with the magnitude of muscle O₂ desaturation in healthy young individuals and older adults at risk for cardiovascular disease (CVD). Twenty healthy young individuals and 20 others at risk for CVD participated in the study. The magnitude of ischemic stimulus was determined by calculating the area under curve of TSI signal over 5 min of cuff occlusion period. Oxygen resaturation rate was calculated as the upslope of the TSI signal over 10 s following cuff deflation. There was no significant correlation between FMD and the magnitude of ischemic stimulus in both groups assessed (young: R = 0.327; P = 0.159 and older: R = -0.184; P = 0.436). However, a significant correlation between the magnitude of O₂ desaturation and O₂ resaturation rate in young (R = 0.555; P = 0.011) and older individuals at risk for CVD (R = 0.539; P = 0.014). In conclusion, FMD response did not correlate with the magnitude of muscle O₂ desaturation, although it seems to be partially associated with O₂ resaturation rate.

The effects of aging and cardiovascular risk factors on microvascular function assessed by near-infrared spectroscopy

This study aimed to evaluate whether NIRS-derived reperfusion rate would detect potential differences in the forearm microvascular responsiveness between young healthy adults, and older adults free from or with cardiovascular disease (CVD) risk factors. Fifteen healthy young (age: 24.8 ± 4.0 years), seventeen older adults free of CVD risk factors (age: 67.0 ± 6.8 years), and twenty-three older adults with CVD risk factors (age: 67.9 ± 8.0 years) participated this study. Individuals underwent a blood draw and vascular occlusion test (30 s of baseline, 5 min of occlusion, and 2 min of reperfusion) and microvascular responsiveness was evaluated by using NIRS-derived tissue oxygen saturation indexes during reperfusion. A significant slower reperfusion rate and lower reperfusion magnitude was observed in older adults with CVD risk factors compared to healthy young and older adults. Although no statistical differences were found between healthy young and older individuals, there was a small (d = 0.4) effect size for reperfusion rate and moderate (d = 0.7) effects size for reperfusion magnitude when comparing these groups. In conclusion, this study demonstrated that even though the effects of aging per se on microvascular function should not be completely neglected, the CVD risk factors seem to be determinant on microvascular responsiveness impairment associated with aging.

Assessing estuarine environmental quality using fish-based indices: performance evaluation under climatic instability

The seasonal variation of five selected multimetric indices for the determination of the Ecological Quality Status (EQS) of transitional waters was evaluated, as well as the indices' responses to an extreme drought event that occurred in 2005. The database used regards the Mondego River estuary, which was sampled from June 2003 to August 2006 on a monthly basis. Among the selected indices (EBI-Deegan et al. [Deegan, L., Finn, J.T., Ayvazlan, S.G., Ryder-Kieffer, C.A., Buonaccoesi, J., 1997. Development and validation of an Estuarine Biotic Integrity Index. Estuaries 30(3), 601-617], EDI-Borja et al. [Borja, A., Franco, J., Valencia, V., Bald, J., Muxika, I., Belzunce, M.J., Solaun, O., 2004. Implementation of the European Water Framework Directive from the Basque Country (northern Spain): a methodological approach. Marine Pollution Bulletin 48(3-4), 209-218], EFCI-Harrison and Whitfield [Harrison, T.D., Whitfield, A.K., 2004. A multi-metric fish index to assess the environmental condition of estuaries. Journal of Fish Biology 65, 683-710], EBI-Breine et al. [Breine, J.J., Maes, J., Quataert, P., Van den Bergh, E., Simoens, I., Van Thuyne, G., Belpaire, C., 2007. A fish-based assessment tool for the ecological quality of the brackish Scheldt estuary in Flanders (Belgium). Hydrobiologia 575, 141-159] and TFCI - Coates et al. [Coates, S., Waugh, A., Anwar, A., Robson, M., 2007. Efficacy of a multi-metric fish index as an analysis tool for the transitional fish component of the Water Framework Directive. Marine Pollution Bulletin 55, 225-240]), the EBI by Breine et al. (2007) was the only that evidenced clear interannual and seasonal variations. The EQS by the several indices ranged from "Low" to "High", depending on the index considered, evidencing the high level of mismatch between indices. The results are discussed in the scope of the EU Water Framework Directive, regarding monitoring strategies, application of indices and EQS assessment.

[Perceived pain and weather changes in rheumatic patients]

INTRODUCTION

Rheumatic patients with chronic pain describe in a vivid way the influence of climate on pain and disease activity. Several studies seem to confirm this association.

OBJECTIVES

To evaluate and compare in a population of rheumatic patients the perceived influence of weather changes on pain and disease activity

METHODS

This is a retrospective cross-sectional study. For three weeks an assisted self-reported questionnaire with nine dimensions and a VAS pain scale was performed on consecutive out-patients in our clinic.

RESULTS

955 patients 787 female 168 male mean age 57.9 years with several rheumatologic diagnosis were evaluated. Overall 70 of the patients believed that the weather influenced their disease and 40 believed that the influence was high. Morning stiffness was influenced in 54 high influenced in 34 . Autumn and Winter were the most influential periods as well as humidity 67 and low temperatures 59 .

CONCLUSION

In our study as well as in literature we found that a high percentage of patients 70 perceived that weather conditions influenced their pain and disease. Fibromyalgia patients seemed to be strongly influenced by weather changes. Our study confirms that patients perception on the influence of climate on pain and therefore their disease is an important clinical factor and it should be considered when evaluating rheumatic patients.

Impact of steatotic grafts on initial function and prognosis after liver transplantation

Steatotic grafts are considered a risk factor for dysfunction or even primary nonfunction of liver transplants; grafts with more than 50% fatty infiltration are routinely discarded. This retrospective study evaluated the impact of macrovesicular and microvesicular steatosis on postoperative initial liver function and prognosis by comparing outcomes to nonsteatotic grafts in 48 liver transplantation patients. Fifteen grafts had macrovesicular steatosis, 13 (27.09%) up to 50% fatty infiltration (MG2), and 2 (4.16%) more than 50% (MG3). Thirty-three (69.75%) grafts had no macrovesicular steatosis (MG1). Initial liver function was adequate in 26 (78.78%), 10 (76.93), and 2 (100%) patients, respectively, in subgroups MG1, MG2, and MG3 (P =.892). Thirty-day survival rates were 90.90%, 100%, and 100%, respectively, in subgroups MG1, MG2, and MG3 (P =.606). Twenty-six grafts showed microvesicular steatosis: 18 (37.50%) showed less than 50% fatty infiltration (mG2), and 8 (16.67%) more than 50% (mG3). Twenty-two (45.83%) grafts had no microvesicular steatosis (mG1). Initial liver function was adequate in 16 (72.72%), 16 (88.88%), and 6 (75%) patients, respectively, in subgroups mG1, mG2, and mG3 (P =.547). Thirty-day survival rates were 90.90%, 100%, and 87.5% respectively, in subgroups mG1, mG2, and mG3 (P =.380). In conclusion, macrovesicular and microvesicular steatotic liver grafts displayed adequate initial function, did not compromise survival, and thus should not be routinely discarded.

Spontaneous hepatitis B surface antigen clearance in a long-term follow-up study of patients with chronic type B hepatitis. Lack of correlation with hepatitis C and D virus superinfection

We investigated the frequency of HBsAg clearance and the possible role of viral superinfection in a long-term follow-up of 184 patients with chronic hepatitis B (CHB). Our subjects were 184 patients with chronic hepatitis B and the follow-up was 12-216 months (mean 66.2 +/- 53.7 months). The investigative methods used were: immunoenzymatic assays for HBV, HCV, HDV, and HIV markers; polymerase chain reaction (PCR) for HBV DNA; and liver biopsy and immunoperoxidase. During the follow-up, 20 of the 184 patients cleared serum HBsAg. A comparison of patients with persistent HBsAg(group I) and of those who cleared this marker (group II) showed a significant difference in mortality (P = 0.002) between the two groups and a tendency to a more severe exacerbation (flare) in group II (P = 0.07). Antibodies to hepatitis C and D virus as well as antibodies to HIV were equally distributed in both groups. Thirteen patients (7.9%) from group I, but none from group II, subsequently developed hepatocellular carcinoma. These results suggest that the frequency of spontaneous clearance of HBsAg during chronic HBV infection is low. No determinant factor for the clearance was found, including the presence of liver cirrhosis. Serum HBV DNA was undetectable by PCR after clearance in 16 out of 17 patients.

Secretory, endoscopic and histopathologic changes and prevalence of Helicobacter pylori in the gastroduodenal mucosa in patients with chronic alcoholic pancreatitis

Aiming at establishing the prevalence of peptic ulcer in chronic alcoholic pancreatitis and an eventual correlation with gastric acid secretion and endoscopic and histopathologic alterations as well as the presence of Helicobacter pylori in the gastroduodenal mucosa, thirty patients with chronic alcoholic pancreatitis (Group I) and ten control subjects (Group II) were prospectively studied. After upper gastrointestinal endoscopy was performed. Group I was subdivided according to the lack (Subgroup Ia) or a presence (Subgroup Ib) of peptic ulcer. The prevalence of peptic ulcer in these patients was 23.33% clearly higher than that reported in the general population. Baseline and stimulated acid secretion as well as baseline gastrinemia among the subgroups and groups were similar. There was no statistically significant difference in the other parameters evaluated. Due to the increased prevalence of asymptomatic peptic ulcer in patients with chronic alcoholic pancreatitis. Upper gastrointestinal endoscopy is suggested as a diagnosis routine and follow-up of this group of patients.