Chios mastiha essential oil exhibits antihypertensive, hypolipidemic and anti-obesity effects in metabolically unhealthy adults - a randomized controlled trial.

The essential oil of the resinous exudate from Pistacia lentiscus of Chios namely Chios Mastiha Essential Oil (CMEO), is a natural volatile oil rich in monoterpenes α-pinene, ß-myrcene, ß-pinene. In the present randomized controlled trial, we investigated the effects of CMEO on individuals with abdominal obesity and metabolic abnormalities i.e., dyslipidemia, hypertension, insulin resistance. Eligible patients (N = 94) were randomly assigned to either the intervention group, receiving capsules containing 200 mg of CMEO daily for 3 months adjunct to current treatment for metabolic disorder(s), or the control group. Anthropometric measurements, blood markers, and quality of life (QoL) were assessed. Statistical analysis was performed on an intention-to-treat basis. A significant improvement in blood lipid profile, namely triglycerides (p = 0.026) and low-density lipoprotein (p = 0.05) of the CMEO group versus controls was observed. Systolic blood pressure (p = 0.05) and alanine aminotransferase (p = 0.022) significantly decreased only after CMEO intake. Alike, weight decreased only in CMEO (p = 0.02), while mean changes in % body fat (p = 0.005) and visceral fat (p = 0.045) were significantly different between groups post-intervention. Lower oxidized LDL (p = 0.044) and higher adiponectin (p = 0.007) were recorded in CMEO with significant different mean changes between groups post-intervention. QoL, as assessed by Short Form-12 questionnaire was improved in the CMEO compared to control (p = 0.041 for Physical Composite Score, p = 0.035 for Mental Composite Score). No adverse effects were reported. An anti-obesity effect of CMEO, probably attributed to modulation of inflammatory and antioxidant processes, is suggested. Conclusively, CMEO can be safe and effective in regulating metabolic abnormalities, adjunct to treatment. (ClinicalTrials.gov. The effect of Mastiha oil in Metabolic Syndrome, ID Number: NCT04785573).

Peripheral inflammation is linked with emotion and mental health in people with obesity. A "head to toe" observational study.

Background: Obesity is a significant worldwide health problem that is linked with mental health. The elucidation of the possible overlapping biochemical mechanism(s) involved in inflammation and oxidative stress is imperative to better understand and address obesity and related metabolic disorders. The aim of the study was to investigate the associations between inflammatory and oxidative stress profiles with parameters that reflect metabolic, emotional, and mental health in a Greek metabolically unhealthy obese cohort. Methods: In total, 122 metabolically unhealthy people with obesity were recruited. Anthropometric measurements, biochemical, inflammatory and oxidative stress markers were assessed. Quality of life was evaluated through questionnaires for insomnia, self-esteem, depression, physical and mental health. Results: The inflammatory biomarker tumor necrosis factor-alpha (TNF-α) and the ratio oxidized low-density lipoprotein/low-density lipoprotein (oxLDL/LDL) were higher in hypertensive (p=0.002, p=0.001 respectively) and hyperglycemic subjects (p=0.017, p=0.001 respectively). Furthermore TNF-α (p<0.001), oxLDL/LDL (p<0.001) and oxLDL/high-density lipoprotein (HDL) (p=0.016) increased significantly with the increase of metabolic syndrome components. Finally, a negative association between interleukin-6 (IL-6) and Rosenberg Self-Esteem Scale (Beta=-0.019, p=0.019) and a positive association between TNF-α and the Center for Epidemiologic Studies Depression Scale Revised (Beta=0.003, p=0.015) were found. Conclusions: The results of the study suggest that obesity-related systemic inflammation is associated with worse self-esteem and depression symptoms, indicating an overlapping mechanism which can be utilized to the management of obesity.

Anthropomorphic phantom for deformable lung and liver CT and MR imaging for radiotherapy.

In this study, a functioning and ventilated anthropomorphic phantom was further enhanced for the purpose of CT and MR imaging of the lung and liver. A deformable lung, including respiratory tract was 3D printed. Within the lung's inner structures is a solid region shaped from a patient's lung tumour and six nitro-glycerine capsules as reference landmarks. The full internal mesh was coated, and the tumour filled, with polyorganosiloxane based gel. A moulded liver was created with an external casing of silicon filled with polyorganosiloxane gel and flexible plastic internal structures. The liver, fitted to the inferior portion of the right lung, moves along with the lung's ventilation. In the contralateral side, a cavity is designed to host a dosimeter, whose motion is correlated to the lung pressure. A 4DCT of the phantom was performed along with static and 4D T1 weighted MR images. The CT Hounsfield units (HU) for the flexible 3D printed material were -600-100 HU (lung and liver structures), for the polyorganosiloxane gel 30-120 HU (lung coating and liver filling) and for the silicon 650-800 HU (liver casing). The MR image intensity units were 0-40, 210-280 and 80-130, respectively. The maximum range of motion in the 4D imaging for the superior lung was 1-3.5 mm and 3.5-8 mm in the inferior portion. The liver motion was 5.5-8.0 mm at the tip and 5.7-10.0 mm at the dome. No measurable drift in motion was observed over a 2 h session and motion was reproducible over three different sessions for sin2(t), sin4(t) and a patient-like breathing curve with the interquartile range of amplitudes for all breathing cycles within 0.5 mm. The addition of features within the lung and of a deformable liver will allow the phantom to be used for imaging studies such as validation of 4DMRI and pseudo CT methods.

A Comparative Assessment of Cardiovascular Autonomic Reflex Testing and Cardiac 123I-Metaiodobenzylguanidine Imaging in Patients with Type 1 Diabetes Mellitus without Complications or Cardiovascular Risk Factors.

AIM: To compare the cardiovascular autonomic reflex tests (CARTs) with cardiac sympathetic innervation imaging with 123I-metaiodobenzylguanidine (MIBG) in patients with type 1 diabetes mellitus (T1DM). PATIENTS AND METHODS: Forty-nine patients (29 males, mean age 36 ± 10 years, mean T1DM duration 19 ± 6 years) without cardiovascular risk factors were prospectively enrolled. Participants were evaluated for autonomic dysfunction by assessing the mean circular resultant (MCR), Valsalva maneuver (Vals), postural index (PI), and orthostatic hypotension (OH). Within one month from the performance of these tests, patients underwent cardiac MIBG imaging and the ratio of the heart to upper mediastinum count density (H/M) at 4 hours postinjection was calculated (abnormal values, H/M < 1.80). RESULTS: Twenty-nine patients (59%) had abnormal CARTs, and 37 (76%) patients had an H/M_4 < 1.80 (p = 0.456). MCR, PI, Vals, and OH were abnormal in 29 (59%), 8 (16%), 5 (10%), and 11 (22%) patients, respectively. When using H/M_4 < 1.80 as the reference standard, a cutoff point of ≥2 abnormal CARTs had a sensitivity of 100% but a specificity of only 33% for determining CAN. CONCLUSIONS: CARTs are not closely associated with 123I-MIBG measurements, which can detect autonomic dysfunction more efficiently than the former. In comparison to semiquantitative cardiac MIBG assessment, the recommended threshold of ≥2 abnormal CARTs to define cardiovascular autonomic dysfunction is highly sensitive but of limited specificity and is independently determined by the duration of T1DM.

Impact of shipping emissions on ozone levels over Europe: assessing the relative importance of the Standard Nomenclature for Air Pollution (SNAP) categories.

The impact of shipping emissions on ozone mixing ratio over Europe is assessed for July 2006 using the Community Multiscale Air Quality modeling system and the Netherlands Organization for Applied Scientific Research anthropogenic emission inventory. Results suggest that ship-induced ozone contribution to the total surface ozone exceeds 5% over the sea and near the coastline, while an increase up to 5% is simulated over a large portion of the European land. The largest impact (i.e., an increase up to 30%) is simulated over the Mediterranean Sea. In addition, shipping emissions are simulated to increase NO2 mixing ratio more than 90%, locally, and to modify the oxidizing capacity of the atmosphere through hydroxyl radical formation (increase by 20-60% over the sea along the European coasts and near the coastal zone). Therefore, emissions from ships may counteract the benefits derived from the anthropogenic emissions reduction strategies over the continent. Simulations suggest regions where shipping emissions have a major impact on ozone mixing ratio compared to individual anthropogenic emission sector categories. Shipping emissions are estimated to play an important role on ozone levels compared to road transport sector near the coastal zone. The impact of shipping emissions on ozone formation is also profound over a great part of the European land compared to the rest of anthropogenic emission categories.

Efficacy of Administration of an Angiotensin Converting Enzyme Inhibitor for Two Years on Autonomic and Peripheral Neuropathy in Patients with Diabetes Mellitus.

Aim. To evaluate the effect of quinapril on diabetic cardiovascular autonomic neuropathy (CAN) and peripheral neuropathy (DPN). Patients and Methods. Sixty-three consecutive patients with diabetes mellitus [43% males, 27 with type 1 DM, mean age 52 years (range 22-65)], definite DCAN [abnormal results in 2 cardiovascular autonomic reflex tests (CARTs)], and DPN were randomized to quinapril 20 mg/day (group A, n = 31) or placebo (group B, n = 32) for 2 years. Patients with hypertension or coronary heart disease were excluded. To detect DPN and DCAN, the Michigan Neuropathy Screening Instrument Questionnaire and Examination (MNSIQ and MNSIE), measurement of vibration perception threshold with biothesiometer (BIO), and CARTs [R-R variation during deep breathing [assessed by expiration/inspiration ratio (E/I), mean circular resultant (MCR), and standard deviation (SD)], Valsalva maneuver (Vals), 30 : 15 ratio, and orthostatic hypotension (OH)] were used. Results. In group A, E/I, MCR, and SD increased (p for all comparisons < 0.05). Other indices (Vals, 30 : 15, OH, MNSIQ, MNSIE, and BIO) did not change. In group B, all CART indices deteriorated, except Vals, which did not change. MNSIQ, MNSIE, and BIO did not change. Conclusions. Treatment with quinapril improves DCAN (mainly parasympathetic dysfunction). Improved autonomic balance may improve the long-term outcome of diabetic patients.

Combination of vinorelbine plus gemcitabine in previously treated patients with small cell lung cancer: a multicentre phase II study.

PURPOSE: To evaluate the efficacy and toxicity of the gemcitabine plus vinorelbine combination in pretreated patients with small cell lung cancer (SCLC). PATIENTS AND METHODS: Thirty-five pretreated patients (median age 59 years, PS: 0--1 in 97% and 2 in 3%) were treated with gemcitabine (1100 mg/m(2)) and vinorelbine (25mg/m(2)) on d1 and d8 every 3 weeks. Seven (20%) patients were treated with two prior regimens and 20 (57%) were refractory to front-line chemotherapy. RESULTS: In an intention-to-treat analysis two (6%) partial responses (PR) were observed with a duration of 5.6 and 11.1 months. Stable disease (SD) was documented in 8 (23%) patients and progressive disease (PD) in 25 (71%). The overall median survival was 4.5 and the 6 months survival rate was 42.6%. Grades 3--4 neutropenia and thrombocytopenia were observed in 25 and 14% of the patients, respectively. Non-hematological toxicity consisted of grade 2 neurotoxicity occurring in 14% of the patients and grades 2--3 fatigue in 17%. Febrile neutropenia was observed in three (8.6%) patients and one of them died from sepsis. CONCLUSION: The combination of gemcitabine plus vinorelbine cannot be considered as an effective salvage treatment in pretreated patients with SCLC.