Incidence of Bacteriobilia and the Correlation with Antibioticoprophylaxis in Low-Risk Patients Submitted to Elective Videolaparoscopic Cholecystectomy: A Randomized Clinical Trial.

Cholelithiasis has a major impact on global health and affects an average of 20% of the Western population. The main risk factors are females, age over 40 years, obesity and pregnancy. Most of the time it is asymptomatic, but when there are symptoms, they are generally nonspecific. Bile was considered sterile, but today it is known that it contains a complex bacterial flora, which causes biofilm in the gallbladder and gallstones. Among the main bacteria associated with cholelithiasis are Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, species of Enterococcus spp. and Acinetobacter spp. Antibiotic prophylaxis is used in an attempt to reduce postoperative infections, especially at the surgical site. However, some authors found no relationship between the use of antibiotic prophylaxis and a lower risk of surgical site infection. Thus, the aim of this double-blind randomized clinical trial was to compare the existence or not of bacteriobilia in patients at low anesthetic risk who underwent videolaparoscopic cholecystectomy, and its correlation with the use of prophylactic antibiotics. This study included 40 patients between 18 and 65 years old, diagnosed with cholelithiasis, symptomatic or not, with low anesthetic risk classified by the American Society of Anesthesiology in ASA I or ASA II, without complications or previous manipulation of the bile duct, who underwent elective video cholecystectomy, divided into two groups: Experimental Group A (n = 20), which received 2 g of Cephalotin (first-generation Cephalosporin, Keflin®, ABL antibiotics, Cosmópolis, Brazil) during anesthetic induction, and Control Group B (n = 20), where no antibiotics were administered until bile collection. After the procedure, a bile sample was collected and culture and antibiogram were performed. In the sample, 22 (55%) were classified as ASA I and 18 (45%) as ASA II. It was observed that 81.8% of the patients who had a positive culture did not use antibiotics, against 18.2% of those who used prophylaxis. When comparing patients regarding anesthetic risk, ASA I patients had a positive culture in 9.1% of cases, against 90.9% in patients classified as ASA II. It was concluded that patients with higher anesthetic risk (ASA II) have a higher chance of bacteriobilia and benefit from antibiotic prophylaxis when compared to patients with lower anesthetic risk (ASA I).

Biochemical and Microbiological Aspects of the Oral Cavity of Children and Young People with Neurological Impairment and Oropharyngeal Dysphagia.

The components and the salivary flow have a direct influence on the composition of the oral microbiota of children and young people with oropharyngeal dysphagia, and studies have already demonstrated the excessive accumulation of supragingival dental calculus in individuals with enteral nutrition. This study aimed to compare the oral hygiene, biochemical, and microbiological aspects of the oral cavity of children and young people with neurological impairment and oropharyngeal dysphagia. Forty children and young people with neurological impairment and oropharyngeal dysphagia were enrolled and divided into two groups: group I, encompassing 20 participants fed via gastrostomy; and group II, encompassing 20 participants fed via the oral route. Oral hygiene and salivary pH and flow were assessed, and a polymerase chain reaction was performed to evaluate the messenger RNA expressions of Porphyromonas gingivalis, Tanerella forsythia, and Treponema denticola. In groups I and II, the mean Oral Hygiene Index-Simplified scores were 4 and 2, respectively, showing a significant difference; the mean Calculus Index scores were 2 and 0, respectively, showing a significant difference; and the mean pH was 7.5 and 6.0, respectively, showing a significant difference. Bacterial analysis indicated no association between the two groups. It can be concluded that children and young people who use gastrostomy had a poorer oral hygiene, greater dental calculus deposition, and higher salivary pH. The saliva of patients in both groups contained Porphyromonas gingivalis, Tanerella forsythia, and Treponema denticola.

Insights into Pathogenesis, Nutritional and Drug Approach in Sarcopenia: A Systematic Review.

Sarcopenia is a multifactorial condition related to the loss of muscle mass and strength due to aging, eating habits, physical inactivity, or even caused by another disease. Affected individuals have a higher risk of falls and may be associated with heart disease, respiratory diseases, cognitive impairment, and consequently an increased risk of hospitalization, in addition to causing an economic impact due to the high cost of care during the stay in hospitals. The standardization of appropriate treatment for patients with sarcopenia that could help reduce pathology-related morbidity is necessary. For these reasons, this study aimed to perform a systematic review of the role of nutrition and drugs that could ameliorate the health and quality of life of sarcopenic patients and PRISMA guidelines were followed. Lifestyle interventions have shown a profound impact on sarcopenia treatment but using supplements and different drugs can also impact skeletal muscle maintenance. Creatine, leucine, branched-chain amino acids, omega 3, and vitamin D can show benefits. Although with controversial results, medications such as Metformin, GLP-1, losartan, statin, growth hormone, and dipeptidyl peptidase 4 inhibitors have also been considered and can alter the sarcopenic's metabolic parameters, protect against cardiovascular diseases and outcomes, while protecting muscles.

Adipokines, Myokines, and Hepatokines: Crosstalk and Metabolic Repercussions.

Adipose, skeletal, and hepatic muscle tissues are the main endocrine organs that produce adipokines, myokines, and hepatokines. These biomarkers can be harmful or beneficial to an organism and still perform crosstalk, acting through the endocrine, paracrine, and autocrine pathways. This study aims to review the crosstalk between adipokines, myokines, and hepatokines. Far beyond understanding the actions of each biomarker alone, it is important to underline that these cytokines act together in the body, resulting in a complex network of actions in different tissues, which may have beneficial or non-beneficial effects on the genesis of various physiological disorders and their respective outcomes, such as type 2 diabetes mellitus (DM2), obesity, metabolic syndrome, and cardiovascular diseases (CVD). Overweight individuals secrete more pro-inflammatory adipokines than those of a healthy weight, leading to an impaired immune response and greater susceptibility to inflammatory and infectious diseases. Myostatin is elevated in pro-inflammatory environments, sharing space with pro-inflammatory organokines, such as tumor necrosis factor-alpha (TNF-α), interleukin-1 (IL-1), resistin, and chemerin. Fibroblast growth factor FGF21 acts as a beta-oxidation regulator and decreases lipogenesis in the liver. The crosstalk mentioned above can interfere with homeostatic disorders and can play a role as a potential therapeutic target that can assist in the methods of diagnosing metabolic syndrome and CVD.

Is Neck Circumference As Reliable As Waist Circumference for Determining Metabolic Syndrome?

Background: Metabolic syndrome (MS) comprises a cluster of risk factors for the development of cardiovascular diseases, which are among the leading causes of morbidity and mortality worldwide. Many studies have shown that neck circumference (NC) has validity in the measure of MS since it correlates positively with the traditional components. For these reasons, this study aimed at comparing waist circumference (WC) and NC for identifying MS parameters in patients treated at a cardiology unit. Methods: This study included 309 patients assisted in a Cardiology Unit. Biochemical and anthropometric parameters were evaluated. Correlations between neck and WC with anthropometric, biochemical, and atherogenic indices were evaluated. The diagnostic ability of neck and WC was assessed by using the receiver operating characteristics curve. Results: The patients had a mean age of 57.2 years, and 56% were men. The diagnosis of MS was present in 48% of men and 39% of women. Neck and WC showed a positive correlation with each other, and both showed positive correlations with the criteria for MS. Moreover, NC showed a positive correlation with body mass index (BMI), insulin, homeostatic model assessment (HOMA)-ß, and C-reactive protein. WC showed a positive correlation with BMI, HOMA of insulin resistance (HOMA-IR), and Castelli Index I. Both neck and WC showed the ability to identify the presence of the MS. Conclusion: Both neck and WC showed a significant correlation with several of the metabolic parameters, including some used as criteria for the diagnosis of MS. In addition, both measures demonstrated a good ability to predict MS, making these measures promising for screening patients with this syndrome.

Effects of Consumption of Coconut and Cow's Milk on the Metabolic Profile of Wistar Rats Fed a Hyperprotein Diet.

The intake of milk has decreased over the past few decades in Western populations and has been replaced by drinks of plant origin. Substitution of cow's milk by vegetable drinks occurs for some reasons, such as the presence of lactose intolerance, reduced calorie intake, prevention of obesity, vegan diets, and concern about the use of hormone therapy and its possible residues in bovine milk. For these reasons, the objective of this study was to evaluate the biochemical and anthropometric profile of animals subjected to a diet supplemented with coconut milk. Animals were divided into six groups (G1-G6), treated, respectively, regular diet and coconut milk or cow's milk, and with a high-protein content diet and coconut milk or cow's milk. Our results showed that the animals treated with coconut milk reduced body weight and visceral fat, and also showed that the use of a high-protein diet in association with coconut milk is a good combination in reducing visceral fat, percentage of weight gain, food intake, cholesterol, and triglycerides. Our results do not show substantial metabolic changes when comparing the use of coconut milk with the use of cow's milk (we cannot say that the coconut milk itself can be better than cow's milk in the evaluated metabolic parameters).

Effects of Green and Ripe Coffee in the Metabolic Profile and Muscle Enzymes in Animals Practicing Physical Exercise.

Many studies have shown that plants can be therapeutic alternatives in the prevention or treatment of various diseases. Among these, green coffee may present different pharmacological effects related to the regulation of glycemia and lipid metabolism and is related to the prevention of cardiovascular diseases. The objective of our study was to evaluate the effects of using green and ripe coffee on the metabolic profile and muscular enzymes after the practice of physical exercises in Wistar rats. We included six groups: G1 (control group), G2 (group submitted to swimming), G3 (group that consumed green coffee), G4 (group that consumed green coffee and was submitted to swimming), G5 (group that consumed ripe coffee), and G6 (group that consumed ripe coffee and was submitted to swimming). Our results showed that there was a significant reduction in the percentage of visceral fat in G3, G5, and G6. We did not observe significant modifications in glycemia, lipids, lactate dehydrogenase, ferric reducing ability of plasma, and ferric-xylenol orange. The levels of creatine phosphokinase showed a reduction in the groups G2 and G4. No significant differences were found in the atherogenic indices. There is a global demand for natural compounds that can be safe, cheap, related to minimum side effects, and provide health benefits. Our results show that the use of green or ripe coffee may contribute to reduce the percentage of visceral fat and consequently may protect against further complications once this tissue produces proatherogenic hormones. Furthermore, green coffee may play a role in protecting muscle injury after the practice of physical exercises.

Dipteryx alata Vogel May Improve Lipid Profile and Atherogenic Indices in Wistar Rats Dipteryx alata and Atherogenic Indices.

Worldwide prevalence of noncommunicable chronic degenerative diseases is among the main causes of death worldwide. The consumption of some foods such as nuts and seeds may be beneficial in preventing these diseases. Dipteryx alata Vogel (DA), known popularly as Baru, belongs to the family Fabaceae and is a native fruit tree from the Brazilian savanna. The purpose of this study was to evaluate the use of seeds of DA on the metabolic and oxidative profile of Wistar rats. Animals were divided randomly into four groups (n = 10): G1 (control group), and G2 (treated with DA 20%), G3 (treated with DA 30%), and G4 (treated with DA 40%). After 40 days, animals were euthanized and metabolic and oxidative profiles were analyzed (glycemia, cholesterol, triglycerides [TGs], high-density lipoprotein-cholesterol [HDL-c], very low-density lipoprotein-cholesterol [VLDL-c], low-density lipoprotein-cholesterol [LDL-c], C reactive protein, aspartate aminotransferase, alanine aminotransferase, Lee index, weight, visceral fat, ferric reducing ability of plasma, and ferric-xylenol orange method. The use of the seeds was effective in reducing TGs, VLDL-c, LDL-c, and increasing HDL-c but did not interfere in the percentage of weight gain, visceral fat, levels of total cholesterol, and oxidative stress. Based on our results, it is possible to say that the use of DA may improve the lipid profile of Wistar rats and we may suggest that the consumption of DA almonds or products prepared with them may be an effective option for the intake of healthy products.

Hypertension, C Reactive Protein and Metabolic Profile: What is the Scenario in Patients Undergoing Arteriography?

INTRODUCTION: High Blood Pressure (HBP), Diabetes Mellitus (DM), Metabolic Syndrome (MS) and Cardiovascular Diseases (CVD) are among the main causes of death worldwide and HBP is one of the most common chronic health problem representing an important and modifiable risk factor for vascular events and mortality. AIM: To study the association among high sensitivity CRP levels, and the biochemical, and anthropometric profile in hypertensive and non-hypertensive patients who underwent arteriography. MATERIALS AND METHODS: This research was performed at the Haemodynamic Laboratory of the University Hospital in the city of Marilia - state of São Paulo, Brazil. Ninety-five subjects who underwent arteriography were included. Anthropometric (body mass index and waist circumference) and biochemical parameters (glycaemia, total cholesterol, HDL-c, LDL-c, triglycerides, and high sensitivity C reactive protein), were evaluated. Variables pertaining to blood pressure, atherogenic indices, diagnosis of metabolic syndrome and catheterization details were collected. Statistical analysis was performed with Chi-square test, Fisher, Student t-test and ANOVA complemented by Tukey test. RESULTS: Our results showed that 78.95% of the patients who underwent arteriography were suffering from HBP. Hypertensive individuals had significantly higher glycaemia (124.14±45.33 mg/dL) or DM, higher values of triglycerides (195.27±74.52 mg/dL), waist circumference (98.52±12.52 cm), body mass index (29.99±1.41 kg/m2) and hs-CRP (0.53±0.44 mg/dL). Most of the hypertensive patients (93.33%) presented with MS and were related to the presence of more severe lesions in the arteries and had passed through more invasive procedures like angioplasty and surgery. CONCLUSION: Our findings indicate that blood pressure control is of paramount importance to ensure better quality of life and life expectancy as it is associated with several risk factors that increase the morbidity and mortality.

Metabolic syndrome and C reactive protein in patients undergoing angiography: Inevitable association?

BACKGROUND: The Metabolic Syndrome (MS) is characterized by a set of risk factors, which causes metabolic and inflammatory changes that increase vascular risk and may promote the development of atherosclerosis. Changes in lifestyle are related to obesity and associated diseases such as hypertension, type 2 diabetes mellitus, MS and cardiovascular disease (CVD). AIMS: This study aimed to evaluate the relationship of MS components and high sensitivity C Reactive Protein (hsCRP) in patients undergoing arteriography. METHODS: A group of patients undergoing arteriography was recruited in order we could evaluate the metabolic profile, levels of hsCRP and number of obstructions in the arteries. RESULTS: Most of our patients underwent arteriography are more likely to have hypertension, glucose intolerance, dyslipidemia, and central obesity, thus, MS is prevalent in this group. They also tend to exhibit higher values of hsCRP, lower values ​​for the estimative of the size of the LDL-c particle and higher number of obstruction in the arteries. CONCLUSION: We may say that the improvement of the above parameters could reduce inflammation and oxidative stress and vascular damages what would extend life expectancy and quality of life of this group of patients.

Pereskia aculeata Miller Flour: Metabolic Effects and Composition.

Pereskia aculeata Miller is known in Brazil as ora-pro-nobis (OPN) and has been used commonly in the folklore medicine. The purpose of our study was to evaluate the composition and the effects of OPN flour on the metabolic profile and intestinal motility of Wistar rats. Animals were divided randomly into five groups (n = 10): G1 (control group) and G2 (treated with OPN flour). For the intestinal motility: G3 (control group), G4 (treated with senne), and G5 (treated with OPN flour). After 40 days, G1 and G2 were euthanized and metabolic profiles were analyzed (glycemia, cholesterol, triglycerides, high density lipoprotein [HDL-c], C reactive protein, AST, ALT, Lee Index, weight, and visceral fat). The flour of OPN was effective in reducing percentage of weight gain, visceral fat, levels of total cholesterol, triglycerides, low density lipoprotein, very low density lipoprotein, and increased HDL-c. Significance was also found in the distance covered by the activated charcoal from the pylorus to the beginning of the cecum, which was higher in animals treated with OPN. Our results indicate that OPN flour may bring health benefits, as the improvement of the intestinal motility, and it is associated with reduction of visceral fat and lipid profile, as well as the increase of HDL-c levels. With these results, we may suggest that the incorporation of this flour in different industrial products may be a convenient and effective way for the intake of healthier products.

Antidiabetic and antilipidemic effects of Manilkara zapota.

Manilkara zapota is a tropical evergreen tree belonging to the Sapotaceae family; its parts are used in alternative medicine to treat coughs and colds and possess diuretic, antidiarrheal, antibiotic, antihyperglycemic, and hypocholesterolemic effects. There are no studies on metabolic profile after using the fruit, and this study aimed at evaluating the effects of the leaf and pulp of M. zapota fruit on the metabolic profile of Wistar rats. Male rats were treated for 50 days with M. zapota leaf juice or fruit juice, after which their biochemical and body composition profiles were analyzed (glycemia, triglycerides, high-density lipoprotein cholesterol (HDL-c), insulin, leptin, aspartate transaminase, alanine aminotransferase, Lee Index, and body mass index). Our results indicate significantly lower levels of glycemia, insulin, leptin, cholesterol, and triglycerides and augmented levels of HDL-c in animals treated with the leaves or fruit of this plant. The percentage of weight gain also declined in animals treated with M. zapota fruit pulp. The use of the M. zapota may be helpful in the prevention of obesity, diabetes, dyslipidemia, and their complications.

Estudo da presença de síndrome metabólica e relação com o histórico familiar em escolares / Study of the presence of metabolic syndrome and its relationship with the familiar history in students

Este trabalho tem por objetivo avaliar a prevalência de Síndrome Metabólica (SM) e a influência do histórico familiar em estudantes de escolas públicas e privadas. Foram avaliados 337 alunos de 2 escolas públicas e 2 particulares do Município de Marília-SP. Foram colhidos dados de peso, altura, índice de massa corpórea, circunferência da cintura, pressão arterial e aferições bioquímicas em jejum de glicemia, colesterol total, HDL-c, LDL-c e triglicerídeos. Observou-se que dos 337 alunos avaliados, 18,4% apresentam a SM. Dos portadores de SM: 92,8% nas escolas particulares apresentavam histórico familiar e 85,3% nas públicas. Do total de alunos estudados, 15,4% eram obesos e 54,0% sedentários. Aalta prevalência da SM nos adolescentes indica a possibilidade de apresentarem complicações cardíacasna fase adulta. Sendo assim, são necessárias medidas intervencionistas urgentes, abordadas por equipemultidisciplinar para que este grupo etário seja assistido integralmente para que se tornem indivíduos adultos mais saudáveis.

This work had as aim to evaluate the predominance of Metabolic Syndrome (SM) and the influence of the familiar historical at adolescents of public and private schools. There were studied 337 pupils of public and private schools in the city of Marília - SP. The following data were evaluated: IMC, waistcircumference, blood pressure and biochemical profile (glycemia, total cholesterol, HDL-c, LDL-c andtriglycerides and 18,4% of the pupils already presented the SM. Of the bearers of SM in the private schools, 92,8% presented familiar historical and 85,3% in the public ones; 15,4% of the adolescent were classified as obese and a 54,0% as sedentary people. The presence of SM in the adolescents indicates the possibility to present cardiac complications in the adult phase. It is necessary that government starts an interventionist work boarded by multidiscipline team to assist this group so that they become healthieradult individuals.

Annona montana fruit and leaves improve the glycemic and lipid profiles of Wistar rats.

Species of the family Annonaceae has been used traditionally as a medicinal plant in tropical regions of South and North America and in Africa. Annona montana is known popularly as false graviola and originates from tropical America and can be cultivated throughout Brazil. There are no studies in the literature that associate A. montana with the metabolic profile of animals. Therefore, the purpose of this work was to assess the effects of the consumption of pulp and leaves of this plant on the metabolic profile of Wistar rats. The animals, which were treated for 40 days, were divided into two control groups--treated with water via gavage and ad libitum, respectively, and two treated groups--one treated with leaf juice and the other with pulp juice of the fruit. Glycemia, lipids, and body weight were found to decrease and high density lipoprotein-cholesterol (HDL-c) levels to increase in the animals treated with leaf juice. The group treated with pulp juice showed a reduction in lipids and augmented HDL-c. The use of A. montana may have beneficial effects in the prevention of diabetes mellitus and dyslipidemia and may thus contribute to the prevention of cardiovascular diseases.

Metabolic Profile of Offspring from Diabetic Wistar Rats Treated with Mentha piperita (Peppermint).

This study aimed at evaluating glycemia and lipid profile of offspring from diabetic Wistar rats treated with Mentha piperita (peppermint) juice. Male offspring from nondiabetic dams (control group: 10 animals treated with water and 10 treated with peppermint juice) and from dams with streptozotocin-induced severe diabetes (diabetic group: 10 animals treated with water and 10 treated with peppermint juice) were used. They were treated during 30 days, and, after the treatment period, levels of glycemia, triglycerides, total cholesterol, and fractions were analyzed in the adult phase. The offspring from diabetic dams treated with peppermint showed significantly reduced levels of glucose, cholesterol, LDL-c, and triglycerides and significant increase in HDL-c levels. The use of the M. piperita juice has potential as culturally appropriate strategy to aid in the prevention of DM, dyslipidemia, and its complications.

Effects of Passiflora edulis on the metabolic profile of diabetic Wistar rat offspring.

Dry extract of the genus Passiflora has been shown to help control glycemia and lipid levels. The objective of this study was to evaluate the effects of passion fruit (P. edulis) on the biochemical profile of offspring from diabetic rats. Diabetes was induced by streptozotocin. The diabetes group consisted of 10 rats with glucose levels greater than 200 mg/dL; the nondiabetic (control) group consisted of 10 rats with glucose levels less than 120 mg/dL. After the diagnosis of diabetes, the mating phase was started. By day 21 of pregnancy, the offspring were born; the dams were kept in individual cages with their offspring until the weaning period. The offspring were then divided into 4 groups (n=15 each): G1 were offspring from control dams, G2 were offspring from treated nondiabetic dams, G3 were offspring from diabetic dams, and G4 were offspring from treated diabetic dams. For 30 consecutive days, G1 and G3 offspring were treated with vehicle (oral gavage) and G2 and G4 offspring were treated with passion fruit juice (oral gavage). After 30-day treatment, the animals were anesthetized and killed, and blood was drawn immediately for analysis of the biochemical profile (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, and glucose). The G2 and G4 rats showed significantly reduced total cholesterol, triglyceride, and low-density lipoprotein cholesterol levels and an increased high-density lipoprotein cholesterol level. The use of passion fruit juice improved lipid profiles, suggesting that this plant may have beneficial effects in the prevention and treatment of dyslipidemias and hyperglycemia.