The changes on salivary flow rates, buffering capacity and chromogranin A levels in adults after bariatric surgery.

OBJECTIVES: This study aimed to investigate changes in salivary flow rates, buffering capacity, and salivary chromogranin A (CHGA) levels in adults undergoing bariatric surgery (BS) compared with a non-obese control group. MATERIALS AND METHODS: Salivary analyses were performed on 62 participants aged over 50 years, stratified into two groups matched for age and gender-individuals who had undergone bariatric surgery (BS) (n = 31) and a corresponding healthy control group (n = 31). Before saliva collection, participants completed a comprehensive 11-point visual numerical rating scale (NRS 0-10) xerostomia questionnaire, assessing subjective perceptions of two key aspects: dryness of the oral mucosa and resultant impact on oral functional ability. Three distinct saliva measurements were obtained: unstimulated whole saliva (UWS), stimulated whole saliva (SWS), and unstimulated upper labial saliva (ULS). The buffering capacity of unstimulated saliva was assessed using pH indicator strips, and concentrations of salivary Chromogranin A (CHGA) were quantified in stimulated saliva via enzyme-linked immunosorbent assay (ELISA). RESULTS: After BS, more than 40% of BS group patients reported xerostomia, with 16.1% experiencing only mild symptoms without significant functional impact (p = 0.009). The prevalence of xerostomia and tongue dryness was higher in the BS group compared to the control group (p = 0.028 and p = 0.025, respectively). The comparative analysis unveiled no statistically significant differences in flow rates of unstimulated upper labial saliva (ULS), unstimulated whole saliva (UWS), and stimulated whole saliva (SWS) between the control group and patients who underwent bariatric surgery. However, in patients undergone BS with xerostomia, both ULS and UWS flow rates were significantly lower than in controls with xerostomia (p = 0.014 and p = 0.007, respectively). The buffering capacity was significantly lower in patients undergone BS than in controls (p = 0.009). No differences were found between groups regarding CHGA concentration and output values, nevertheless, higher values of CHGA concentrations were significantly correlated to lower flow rates. CONCLUSION: According to the results, this study suggests that individuals undergoing BS may exhibit altered salivary buffering capacity and reduced unstimulated salivary flows in the presence of xerostomia. Additionally, the findings suggest that elevated concentration of salivary CHGA might be associated, in part, with salivary gland hypofunction. CLINICAL RELEVANCE: The clinical significance of this study lies in highlighting the changes in salivary functions after BS. The identified salivary alterations might be attributed to adverse effects of BS such as vomiting, gastroesophageal reflux, and dehydration. Understanding these changes is crucial for healthcare professionals involved in the care of post-BS patients, as it sheds light on potential oral health challenges that may arise as a consequence of the surgical intervention. Monitoring and managing these salivary alterations can contribute to comprehensive patient care and enhance the overall postoperative experience for individuals undergoing BS.

Comparative evaluation of inflammatory parameters and substitute insulin resistance indices in elderly women with and without type 2 diabetes mellitus.

PURPOSE: To analyze the influence of inflammatory parameters and substitute insulin resistance indices on the risk of type 2 diabetes mellitus (DM) development in elderly women, as well as to compare anthropometric measures and metabolic parameters according to the presence of type 2 DM and HbA1c levels. PATIENTS AND METHODS: One hundred and twenty elderly women (67.9 ± 6.0 years) were submitted to anthropometric analysis, determination of inflammatory and metabolic parameters. They also underwent indices of lipid accumulation product (LAP), high density triglyceride/lipoprotein ratio (TG/HDL), triglyceride glucose index (TyG), as well as TyG by body mass index (BMI) ratio (TyG-BMI) assessment. RESULTS: Body mass index, tumor necrosis factor alpha, interleukin-2, blood glucose, TG, LAP, TG/HDL, TyG and TyG-BMI were significantly higher in elderly women with DM compared to non-diabetic women. LAP ≥ 55.4 (OR = 2.29; P = .027); TyG ≥ 8.8 (OR = 3.52; P < .001) and TyG-BMI ≥ 264.8 (OR = 3.54; P = .001) were identified as risk factors for DM. CONCLUSION: High pro-inflammatory parameters, low levels of anti-inflammatory markers and higher levels of substitute insulin resistance indices are risk predictors for DM development in elderly women in primary health care.

Mathematical models applied to thyroid cancer.

Thyroid cancer is the most prevalent endocrine neoplasia in the world. The use of mathematical models on the development of tumors has yielded numerous results in this field and modeling with differential equations is present in many papers on cancer. In order to know the use of mathematical models with differential equations or similar in the study of thyroid cancer, studies since 2006 to date was reviewed. Systems with ordinary or partial differential equations were the means most frequently adopted by the authors. The models deal with tumor growth, effective half-life of radioiodine applied after thyroidectomy, the treatment with iodine-131, thyroid volume before thyroidectomy, and others. The variables usually employed in the models includes tumor volume, thyroid volume, amount of iodine, thyroglobulin and thyroxine hormone, radioiodine activity, and physical characteristics such as pressure, density, and displacement of the thyroid molecules. In conclusion, the mathematical models used so far with differential equations approach several aspects of thyroid cancer, including participation in methods of execution or follow-up of treatments. With the development of new models, an increase in the current understanding of the detection, evolution, and treatment of diseases is a step that should be considered.

The Role of the NIS (SLC5A5) Gene in Papillary Thyroid Cancer: A Systematic Review.

Papillary thyroid cancer (PTC) is the most common thyroid malignancy. Genetic and epigenetic alterations play a decisive role in the onset of several human neoplasms. Mutations and polymorphisms are two frequent genetic alterations. Located on chromosome 19 (19p13.11), the NIS SLC5A5 (solute carrier family 5 member 5) gene encodes a highly specialized and efficient 80-90 kDa transmembrane glycoprotein that mediates active transport of iodide from the bloodstream into the follicular cells. Given the highly significant role of NIS in the physiology and the cancer pathogenesis process, this paper's objective is to provide a comprehensive assessment of the associations between NIS gene and protein with papillary thyroid cancer.

Association between -308G/A TNFA Polymorphism and Susceptibility to Type 2 Diabetes Mellitus: A Systematic Review.

Diabetes mellitus (DM) is considered to be a worldwide epidemic disease and its type 2 form comprises more than 95% of all cases. Tumor necrosis factor-alpha (TNF-α) is a proinflammatory cytokine. Its dysregulation has been implicated in a variety of human diseases, including type 2 diabetes mellitus (T2DM). The control of expression of this cytokine is associated with insulin resistance and has a strong genetic influence. In order to understand this relationship, the literature from all case-control studies since 2000 to date was reviewed. The genotypes frequency results presented in ten publications with different ethnicities were compared. The correlation between the TNFA promoter genotypes and the risk of developing T2DM remains controversial due to the many discrepancies between the different studies available. Ethnic differences may play a role in these conflicting results, since the distribution of TNFA promoter polymorphisms is distinctive between individuals of dissimilar racial origin. Hence, although the relationship between T2DM incidence and presence of polymorphisms at position -308 of the TNFA gene is not entirely clear, the results of these studies suggest the need for further investigation.