Sex differences in food choices, adherence to dietary recommendations and plasma lipid profile in type 2 diabetes - The TOSCA.IT study.

BACKGROUND AND AIMS: Diabetic women have a more adverse plasma lipid profile than men. Sex differences in dietary habits may play a role, but are little investigated. The study evaluates the quality of diet, adherence to the nutritional recommendations of the Diabetes and Nutrition Study Group and their relation with plasma lipid in men and women with diabetes. METHODS AND RESULTS: We studied 2573 people, aged 50-75, enrolled in the TOSCA.IT study (clinicaltrials.gov; NCT00700856). Plasma lipids were measured centrally. Diet was assessed with a semi-quantitative food frequency questionnaire. Women had a more adverse plasma lipid profile than men. Women consumed significantly more legumes, vegetables, fruits, eggs, milk, vegetable oils, and added sugar, whereas men consumed more starchy foods, soft drinks and alcoholic beverages. This stands for a higher proportion (%) of energy intake from saturated fat and added sugar (12.0 ± 2.4 vs 11.5 ± 2.5 and 3.4 ± 3.2 vs 2.3 ± 3.2, P < 0.04), and a higher intake of fiber (11.2 ± 2.8 vs 10.4 ± 2.6 g/1000 Kcal/day) in women. Adherence to the recommendations for saturated fat and fiber consumption was associated with significantly lower LDL-cholesterol regardless of sex. Adherence to the recommendations for added sugars was associated with significantly lower triglycerides and higher HDL-cholesterol in men and women. CONCLUSIONS: Men and women with diabetes show significant differences in adherence to nutritional recommendations, but sex differences in plasma lipid profile are unlikely to be explained by nutritional factors. Adherence to the nutritional recommendations is associated with a better plasma lipid profile regardless of sex, thus reinforcing the importance of substituting saturated for unsaturated fat sources, increasing fiber and reducing added sugar intake.

Comparative study of inorganic elements determined in whole blood from Dmd(mdx)/J mice strain by EDXRF and NAA analytical techniques.

Several diseases can be diagnosed observing the variation of specific elements concentration in body fluids. In this study the concentration of inorganic elements in blood samples of dystrophic (Dmd(mdx)/J) and C57BL/6J (control group) mice strain were determined. The results obtained from Energy Dispersive X-ray Fluorescence (EDXRF) were compared with Neutron Activation Analysis (NAA) technique. Both analytical techniques showed to be appropriate and complementary offering a new contribution for veterinary medicine as well as detailed knowledge of this pathology.

Influence of dietary fat and carbohydrates proportions on plasma lipids, glucose control and low-grade inflammation in patients with type 2 diabetes-The TOSCA.IT Study.

PURPOSE: The optimal macronutrient composition of the diet for the management of type 2 diabetes is debated, particularly with regard to the ideal proportion of fat and carbohydrates. The aim of the study was to explore the association of different proportions of fat and carbohydrates of the diet-within the ranges recommended by different guidelines-with metabolic risk factors. METHODS: We studied 1785 people with type 2 diabetes, aged 50-75, enrolled in the TOSCA.IT Study. Dietary habits were assessed using a validated food-frequency questionnaire (EPIC). Anthropometry, fasting lipids, HbA1c and C-reactive protein (CRP) were measured. RESULTS: Increasing fat intake from <25 to ≥35 % is associated with a significant increase in LDL-cholesterol, triglycerides, HbA1c and CRP (p < 0.05). Increasing carbohydrates intake from <45 to ≥60 % is associated with significantly lower triglycerides, HbA1c and CRP (p < 0.05). A fiber intake ≥15 g/1000 kcal is associated with a better plasma lipids profile and lower HbA1c and CRP than lower fiber consumption. A consumption of added sugars of ≥10 % of the energy intake is associated with a more adverse plasma lipids profile and higher CRP than lower intake. CONCLUSIONS: In people with type 2 diabetes, variations in the proportion of fat and carbohydrates of the diet, within the relatively narrow ranges recommended by different nutritional guidelines, significantly impact on the metabolic profile and markers of low-grade inflammation. The data support the potential for reducing the intake of fat and added sugars, preferring complex, slowly absorbable, carbohydrates.

Na, K, Ca, Mg, and U-series in fossil bone and the proposal of a radial diffusion-adsorption model of uranium uptake.

Fossil bones are often the only materials available for chronological reconstruction of important archeological sites. However, since bone is an open system for uranium, it cannot be dated directly and therefore it is necessary to develop models for the U uptake. Hence, a radial diffusion-adsorption (RDA) model is described. Unlike the classic diffusion-adsorption (D-A) model, RDA uses a cylindrical geometry to describe the U uptake in fossil bones. The model was applied across a transverse section of a tibia of an extinct megamammal Macrauchenia patachonica from the La Paz Local Fauna, Montevideo State, Uruguay. Measurements of spatial distribution of Na, K, Ca, and Mg were also performed by neutron activation analysis (NAA). Gamma-ray spectrometric U-series dating was applied to determine the age of the bone sample. From U concentration profile, it was possible to observe the occurrence of a relatively slow and continuous uranium uptake under constant conditions that had not yet reached equilibrium, since the uranium distribution is a ∪-shaped closed-system. Predictions of the RDA model were obtained for a specific geochemical scenario, indicating that the effective diffusion coefficient D/R in this fossil bone is (2.4 ± 0.6)10(-12) cm(2)s(-1). Mean values of Na, K, Ca, and Mg contents along the radial line of the fossil tibia are consistent with the expected behavior for spatial distributions of these mineral elements across a modern bone section. This result indicates that the fossil tibia may have its mineral structure preserved.

Temporal evolution of ¹³7Cs⁺, K⁺ and Na⁺ in fruits of South American tropical species.

Concentrations of (137)Cs, K and Na in fruits of lemon (Citrus limon B.) and of K and Na in fruits of coconut (Cocos nucifera L.) trees were measured by both gamma spectrometry and neutron activation analysis, with the aim to understand the behaviour of monovalent inorganic cations in tropical plants as well as the plant ability to store these elements. Similar amounts of K(+) were incorporated by lemon and coconut trees during the growth and ripening processes of its fruits. The K concentration decreased exponentially during the growth of lemons and coconuts, ranging from 13 to 25 g kg(-1) dry weight. The incorporation of Na(+) differed considerably between the plant species studied. The Na concentration increased linearly during the lemon growth period (0.04 to 0.70 g kg(-1) d.w.) and decreased exponentially during the coconut growth period (1.4 to 0.5 g kg(-1) d.w.). Even though radiocaesium is not an essential element to plants, our results have shown that (137)Cs incorporation to vegetable tissues is positively correlated to K distribution within the studied tropical plant species, suggesting that the two elements might be assimilated in a similar way, going through the biological cycle together. A mathematical model was developed from the experimental data allowing simulating the incorporation process of monovalent inorganic cations by the fruits of such tropical species. The agreement between the theoretical approach and the experimental values is satisfactory along fruit development.

Necrotizing enterocolitis in multiple gestations: comparison with singletons.

AIM: The purpose of this study is to describe the incidence of necrotising enterocolitis in multiple pregnancies and compare it with single pregnancies, pinpointing any risk and morbidity factors. METHODS: A retrospective study of patients admitted to the neonatal pathology department of our hospital was carried out. The period considered was January 2002 to January 2009. All clinical records of patients who have developed NEC or suspected NEC were reviewed. Inclusion criteria were created. Risk factors and any other contributing causes in the two main groups (with and without NEC) were analysed. RESULTS: During the study period we considered 409 babies born from multiple pregnancies and 895 from single pregnancies. Ninety-three from multiple pregnancies and 241 from single pregnancies were considered suitable for the study. The percentage of NEC in multiple pregnancies (18%) was higher than in the singles (4%) (P<0.05). The patients with suspected NEC or advanced NEC showed a longer time between birth and the first meconium discharge (5 vs. 2 days, P<0.05). The patients who received intestinal washing from the second day did not develop NEC (<0.05). Mortality was associated with the lower gestational age and a low Apger score at the first minute (P<0.05). CONCLUSION: Analysis shows that the incidence of NEC is higher in multiple pregnancies only if we consider gestational age or in association with severe prematurity. A gestational age <28 weeks and a low Apgar score at the first minute are risk factors for both categories.

Variability of 137Cs and 40K soil-to-fruit transfer factor in tropical lemon trees during the fruit development period.

In this investigation we evaluate the soil uptake of (137)Cs and (40)K by tropical plants and their consequent translocation to fruits, by calculating the soil-to-fruit transfer factors defined as F(v) = [concentration of radionuclide in fruit (Bq kg(-1) dry mass)/concentration of radionuclide in soil (Bq kg(-1) dry mass in upper 20 cm)]. In order to obtain F(v) values, the accumulation of these radionuclides in fruits of lemon trees (Citrus limon B.) during the fruit growth was measured. A mathematical model was calibrated from the experimental data allowing simulating the incorporation process of these radionuclides by fruits. Although the fruit incorporates a lot more potassium than cesium, both radionuclides present similar absorption patterns during the entire growth period. F(v) ranged from 0.54 to 1.02 for (40)K and from 0.02 to 0.06 for (137)Cs. Maximum F(v) values are reached at the initial time of fruit growth and decrease as the fruit develops, being lowest at the maturation period. As a result of applying the model a decreasing exponential function is derived for F(v) as time increases. The agreement between the theoretical approach and the experimental values is satisfactory.

Clinical course of grade I-III megaureters detected on prenatal ultrasound.

AIM: Primary obstructive megaureter has always been considered a developmental defect. The aim of this study was evaluate the clinical course of grade I-III megaureter at a single Institution through a longitudinal observational study. METHODS: Between April 2004 and April 2006 35 cases of megaureter were observed prenatally. Inclusion criteria were created. Conservative treatment was used for all patients and its efficacy was assessed with routine laboratory tests, ultrasounds and renal scintigraphy. Follow-up was at least three years for all patients. RESULTS: Twenty patients were considered for the study. Single or relapsing infections (36% of patients had more than three urinary tract infections during follow-up) did not seem absolute indications for surgical treatment in these patients, although they are currently the first indication for surgery. CONCLUSION: Clinical results of the study showed that conservative treatment is an effective treatment option. Single or relapsing infections are not a clear indication for surgery. Long-term follow-up for these patients is mandatory.

Unilateral hydronephrosis due to ureteropelvic junction obstruction in children: long term follow-up.

AIM: Hydronephrosis is one of the most common urological disease detected on prenatal ultrasound; The aim of this study was evaluate the role of long-term follow-up in patients with unilateral hydronephrosis. METHODS: On January 2009, the medical charts of patients observed at the Department and Institution for unilateral hydronephrosis were reviewed, for a long-term follow-up evaluation (10 years). All diagnosis were done prenatally. Long term follow-up is described. RESULTS: One hundred and seventy-four 174 patients were observed. At diagnosis grading of hydronephrosis was: 3% grade 0, 25% grade I, 41% grade II, 31% grade IV. At the end of the study, 94 patients underwent surgery, while 80 were managed conservatively. CONCLUSIONS: Grade of hydronephrosis and renal function still remain the most important variables to decide the surgical management. Long-term follow-up shows that over the years many patients need surgery.

The role of lifestyle changing to improve the semen quality in patients with varicocele.

AIM: To evaluate the recovery of semen quality in patients with high grade varicocele without hypotrophy and abnormal semen analysis using a simple lifestyle changing protocol. METHODS: Fifty-two patients were eligible for this study. Two semen sample were collected at baseline and other two after treatment. PROTOCOL: patients had to stop or decrease the number of cigarette per day, reduce the coffee and alcohol consumption, introduce fruits and vegetables in the daily diet and have a normal sexual activity with an abstinence of tree days before semen collection. All the variables and the semen parameters were evaluated and correlated between responders and non-responders. RESULTS: Forty patients (76%) had an improvement of semen quality showing a normal semen analysis following the WHO criteria. The other 12 patients had an improvement of the semen quality but without statistical differences. Smokers and drinkers (for both coffee and alcohol) had lower sperm volume, lower sperm motility and vitality when compared to the others. CONCLUSIONS: The analysis of data collected by the spermiograms showed that semen quality could benefit from lifestyle changing. This finding is important for the management of patients with varicocele, suggesting that lifestyle changing could avoid surgery.

Prenatal sonographic evaluation of male genitalia development.

AIM: The aim of this study was to evaluate the sonographic development of normal fetal male genitalia. METHODS: A longitudinal study was performed on 60 male fetuses. The development of penis, prepuce and presence of testes in scrotum were observed with a high resolution transabdominal ultrasonography between weeks 11 and 40. RESULTS: The overall success of identifying correctly the fetal male gender increased with gestational age from 46% to 80%, and 96% at 12, 13 and 14 week, respectively. The number of the scans performed in relation to the gestational age from week 11 to week 14 improves the ability to assign the male gender and to report the penile length (P<0.05); the earliest observations of descend testis were at 24 weeks. The bilateral observation of testicular descend was at 31 weeks in 98% of fetuses. CONCLUSION: Development of male genitalia is easy evaluated through the pregnancy. This could be useful to early identify male genitalia abnormalities.

Effect of moderate aerobic exercise on sympatho-vagal balance in Type 2 diabetic patients.

AIMS: The purpose of the study was to determine long-term cardiovascular autonomic adaptation to moderate endurance aerobic exercise in people with Type 2 diabetes in order to test the hypothesis of an enhanced vagal drive. METHODS: We analysed the power spectral density of heart rate cyclic variations at rest, while lying, and while standing in 12 sedentary, non-smoking, Type 2 diabetic individuals. Testing was performed before and after a 6-month, supervised, progressive, aerobic training programme, twice weekly. Heart rate variability was assessed by autoregressive power spectral analysis (PSA); this method allows reliable quantification of low-frequency (LF) and high-frequency (HF) components, which are considered to be under mainly sympathetic and purely parasympathetic control, respectively. RESULTS: In 10-min electrocardiogram recordings, mean RR intervals values lying and standing were similar before and after physical exercise. Likewise, total heart rate variability, expressed as total power spectral density (PSD), was not altered by exercise. In contrast, on standing, the HF component, expressed in normalized units, was significantly higher (20.1 +/- 4 vs. 30.4 +/- 5, P < 0.01), whereas the LF component was significantly lower (68.1 +/- 7 vs. 49.8 +/- 8, P < 0.01) after exercise; hence, on standing, the LF/HF ratio, reflecting the sympathetic vs. parasympathetic balance, was markedly lower (16.2 +/- 11 vs. 5.2 +/- 3.2, P = 0.003). No significant exercise-related changes in these PSA components were observed on lying. CONCLUSIONS: A twice-weekly, 6-month, moderate, aerobic exercise programme, without a concomitant weight loss diet, is associated with significant improvements in cardiovascular autonomic function in overweight, non-smoking, Type 2 diabetic individuals.

Trisomy 18: Fetal ultrasound findings at different gestational ages.

The aim of this article is evaluate the sonograhic findings in fetuses with trisomy 18 at different gestational ages. The cases were recruited from pregnant women, who underwent to prenatal diagnosis in the period from October 1995 to September 2006. Seventy-one fetuses with trisomy 18 were diagnosed. On review of the sonograms the majority of these cases had ultrasound anomalies (sensitivity of 91.5%). The most frequent anomalies were abnormalities of extremities (40.8%) and fetal growth restriction (35.2%). More frequently (54.9%) two or more anomalies were present. Nearly all fetuses with trisomy 18 had sonographic abnormalities. Likely improved high-resolution equipment and attention to details by skilled operators led to the detection of most anomalies to trisomy 18. Knowledge of types of specific ultrasound findings can improve prenatal diagnosis in order to provide invasive procedures only when indicated, and to avoid amniocentesis when ultrasound signs are not observed in women at high risk from positive biochemical testing.

Caracterizacióndde ácidos húmicos y fúlvicos de un mollisol bajo dos coberturas difreentes / Charaterization of humic and fulvic acids from a mollisol under two diferent coverlands

Para evaluar y comparar algunas propiedades de los ácidos húmicos (AH) y fúlvicos (AF) como el grado de condensación y polimerización, el contenido total de carbono, hidrógeno y nitrógeno, y sus constantes de acidez, se analizó la fracción menor a 50 µm de un Mollisol del horizonte Ap, bajo caña de azúcar, y se comparó con un horizonte A, bajo bosque. Para tal fin se hicieron extracciones sucesivas con tetraborato de sodio 0,05 M, pirofosfato de sodio 0,025 M e hidróxido de sodio 0,1M. Las sustancias húmicas se purificaron mediante tratamientos con ácidos inorgánicos en solución al 1% de HCl y HF, resinas de absorción Amberlita XAD-16 e intercambio catiónico R101H+, diálisis y liofilización, y se caracterizaron por análisis elemental, relación E4/E6 y potenciometría ácido-base de acuerdo con las funciones de Gran modificadas. La relación E4/E6 permitió establecer mayores tamaños moleculares y grado de condensación de los ácidos húmicos en relación con los ácidos fúlvicos. Por potenciometría ácido-base se determinaron, en los ácidos húmicos y ácidos fúlvicos, las concentraciones de grupos funcionales ácidos y sus respectivas constantes de acidez. Dos de éstas, tituladas entre pH 4,0 y 6,1 corresponden a grupos carboxílicos, las otras dos entre pH 7,2 y 8,7 son el resultado de grupos -OH fenólicos fuertes y carboxílicos débiles. En el horizonte Ap, bajo caña de azúcar, los resultados demostraron que las prácticas de uso y manejo de este cultivo han llevado a la homogeneización de las sustancias húmicas, mientras que en el horizonte A bajo bosque existen ácidos húmicos y fúlvicos diferenciados por tamaño molecular, aromaticidad y grado de humificación.

In order to determine and to compare some physicochemical properties of humic (HA) and fulvic (FA) acids such as degree of condensation and polymerization, the total C,H,N content and pKa values were analyzed in the smaller fraction (< 50 m) from Ap horizon under sugarcane crop in opposition to A horizon under forest, both Mollisol order. To carry out this aim, successive extractions with sodium tetraborate 0.05 M, sodium pyrophosphate 0.025 M, and sodium hydroxide 0.1 M were made. The purification of these humic substances by treatment with inorganic acids 1% solutions of HCl and HF, Amberlite XAD-16 adsorption resin and R 101H+ cationic exchange, dialysis and freeze driying were done. The humic and fulvic acids were characterized by elemental analysis, E4/E6 relation and acid-base potentiometry. The ratio E4/E6 allows to establish that molecular size and degree of condensation in humic acids were bigger than in fulvic acids. By means of acid-base potentiometry, the concentrations of functional acid groups and their acid constants in the humic and fulvic acids were determined. Four constants were found; first and second between pH 4.0 and 6.1 correspond to differents kinds of carboxyl groups and another two between pH 7.2 and 8.7 come from strong O-H phenolic and weak carboxyl groups. In the Ap horizon under sugarcane the characterization showed that the handling and land use practices promote the homogeneity of humic substances meanwhile in the A horizon under forest; the humic and fulvic acids are different due to their degree of condensation molecular size and humification index.

Insulin sensitivity and hepatic steatosis in obese subjects with normal glucose tolerance.

BACKGROUND AND AIM: Hepatic steatosis has recently been associated with insulin resistance and other metabolic abnormalities as a possible feature of the metabolic syndrome, but it is still uncertain how hepatic steatosis and insulin sensitivity are connected. Furthermore, obesity is a well characterized insulin resistant condition that is often associated with hepatic steatosis. The aim of this study was to verify whether hepatic steatosis further worsens insulin sensitivity in obese subjects by comparing the degree of insulin sensitivity in obese subjects with normal glucose tolerance on the basis of the presence or absence of hepatic steatosis. METHODS AND RESULTS: We analyzed 86 obese patients whose alcohol intake was less than 20 g/day and who showed no signs of viral hepatopathy. All of the subjects had normal glucose tolerance as shown by an oral glucose tolerance test. Insulin resistance was estimated using the homeostasis model assessment (HOMA) method and the diagnosis of steatosis was determined by an ultrasound scan of the liver. The subjects were comparable in terms of body mass index (BMI), lipid profile and serum uric acid levels; those with hepatic steatosis were slightly older and tended to have higher systolic blood pressure and fasting glycemia levels. The HOMA values were significantly higher in the group with hepatic steatosis (4.48 +/- 2.22 vs 3.11 +/- 1.47, p=0.002). There was no linear correlation between HOMA and alanine aminotransferase (ALT) levels, but a close linear correlation between HOMA and BMI (r=0.40; p<0.001). The effect of hepatic steatosis on HOMA remained significant after adjusting for age and gender (covariance analysis, p=0.006). When BMI was added to the covariance analysis, hepatic steatosis retained its statistical significance. CONCLUSION: Our data suggest that hepatic steatosis can increase insulin resistance independently of obesity.

Long-term accumulation and microdistribution of uranium in the bone and marrow of beagle dog.

The accumulation and microdistribution of uranium in the bone and marrow of Beagle dogs were determined by both neutron activation and neutron-fission analysis. The experiment started immediately after the weaning period, lasting till maturity. Two animal groups were fed daily with uranyl nitrate at concentrations of 20 and 100 microg g(-1) food. Of the two measuring techniques, uranium accumulated along the marrow as much as in the bone, contrary to the results obtained with single, acute doses. The role played by this finding for the evaluation of radiobiological long-term risks is discussed. It was demonstrated, by means of a biokinetical approach, that the long-term accumulation of uranium in bone and marrow could be described by a piling up of single dose daily incorporation.

Determination of neutron flux distribution in an Am-Be irradiator using the MCNP.

A neutron irradiator has been assembled at IPEN facilities to perform qualitative-quantitative analysis of many materials using thermal and fast neutrons outside the nuclear reactor premises. To establish the prototype specifications, the neutron flux distribution and the absorbed dose rates were calculated using the MCNP computer code. These theoretical predictions then allow one to discuss the optimum irradiator design and its performance.

Excited levels in 149Pm from the decay of 149Nd.

The level structure of 149Pm has been investigated by studying the gamma rays emitted following the beta(-) decay of 149Nd (T(1/2)=1.7h). The singles and the gammagamma coincidence spectra were taken using HPGe detectors with high energy resolution. The energy and relative intensities of 198 gamma rays have been determined, 45 for the first time and several multiplets were resolved using bidimensional data analysis. A decay scheme with 51 levels has been proposed. This includes 6 new levels, at 1407, 1368, 1364, 1329, 1293 and 1181keV. The present results permitted assignments of spin and parity for a number of these levels.

Body mass index and the risk of mortality in type II diabetic patients from Verona.

OBJECTIVE: The relation between body weight and mortality in type II diabetic patients has not been fully elucidated. The aim of the present study was to evaluate the impact of body weight on mortality in a well-characterized type II diabetic cohort. RESEARCH DESIGN AND METHODS: We examined a cohort of 3398 type II diabetic patients, alive on December 1986 and followed up for 10 years, to assess mortality and its causes and to investigate the relationship between body mass index (BMI) and mortality from all and specific causes. For this purpose, survival in the different quartiles of BMI was evaluated by a Cox model, controlling for sex, age, treatment, smoking, duration of diabetes, hypertension, and fasting plasma glucose. The Cox model was applied either excluding (model 1) or including (model 2) the last three variables. RESULTS: During the 10 ys of follow-up, 1212 deaths (639 women, 573 men) occurred in the cohort under study. Since the interaction between BMI and age was statistically significant (P = 0.002), survival was studied separately in people aged <65 and > or =65 y (median age of the cohort = 65.9 y). Under 65 y, a significantly higher all-cause mortality was observed in obese patients, that is, in the IV quartile (BMI> or =30.9 kg/m(2); RR = 1.74; CI 95% = 1.26-2.40), in model 1. The inclusion of hypertension, duration of diabetes, and fasting plasma glucose in the model (model 2) slightly decreased the relative risk (RR = 1.52; CI 95% = 1.10-2.11). After 65 y, higher body weight was associated with a better outcome, especially in patients belonging to the IV quartile of BMI (RR = 0.74; CI 95% = 0.62-0.90). CONCLUSIONS: In older type II diabetic patients, a moderate excess weight predicts a better survival, while obesity is a negative prognostic factor in patients younger than 65 y. In the latter patients, the effect of obesity on mortality seems to be partly mediated by hypertension, duration of diabetes, and fasting plasma glucose.

Energy levels in 139La from the decay of 139Ba.

The gamma-ray spectrum of 139La following the beta- decay of 139Ba has been studied using both singles and gammagamma coincidence spectroscopy techniques. The energies and intensities of 30 gamma-transitions have been determined, which include three new transitions placed in the level scheme. Two new levels at 1524.6 and 1900.3 keV excitation energies are proposed and a number of gamma-transitions have been confirmed. On the basis of these results a precise decay scheme is proposed.