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.

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.

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.

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.

Multielemental analyses of Lonomia obliqua (Lepidoptera, Saturniidae) caterpillar using EDXRF and INAA techniques

In this study, multielemental analysis of Lonomia obliqua (Lepidoptera, Saturniidae) caterpillar was performed using energy dispersive X-ray fluorescence and instrumental neutron activation analysis techniques. This caterpillar is poisonous and has the ability to cause fatal hemorrhagic effects in humans after contact. The need of this study is related to morphological changes (mainly size and color) observed in some caterpillars used for preparation of antilonomic serum (antivenom). The samples were classified as healthy (caterpillars of control) and unhealthy (caterpillars visibly modified). The XRF measurements were performed in an energy dispersive X-ray fluorescence spectrometer and the instrumental neutron activation analysis using the IEA-R1 nuclear reactor at IPEN. The results show significant differences for several elements (mainly, P, Cl, Ca, Ti, Mn, Fe, Ni, and Zn) in unhealthy caterpillars that can affect the development of this species as well as the quality and yield of the antivenom. Furthermore, its elemental characterization contributes for the understanding the potential pharmacological (procoagulant and antithrombotic) in the prevention of life-threatening blood clots

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.

Endocrine status in 29 patients treated by curative radiation therapy for nasopharyngeal carcinoma.

The basal endocrine status of 29 patients treated with curative radiation therapy for nasopharyngeal carcinoma was assessed; they were disease-free for a minimum of 4 years from the end of treatment. None showed clinical evidence of endocrine disease, and most of them had a substantially normal hormonal blood pattern. A slightly elevated TSH value, suggesting subclinical primary hypothyroidism, was found only in two male patients, which could be ascribed to the radiotherapeutic treatment of the neck. Although we cannot exclude more subtle alterations of hypothalamic-pituitary function, the percentage incidence of endocrine impairment in our patients seems lower than previously reported by other authors.

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.

Decay of 72Ga.

The gamma-ray spectrum of 72Ge following the beta- decay of 72Ga has been studied using both single and gamma-gamma coincidence spectroscopy techniques. The energies and intensities of 110 gamma-rays have been determined, 26 of them were observed for the first time and 20 have been confirmed. Of the total number of gamma-rays observed, 95 have been placed in a proposed level scheme containing 31 levels. This includes five new levels at 2303, 2694, 3067, 3097 and 3420 keV.

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.

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.

Multielemental analyses of Lonomia obliqua (Lepidoptera, Saturniidae) caterpillar using EDXRF and INAA techniques

In this study, multielemental analysis of Lonomia obliqua (Lepidoptera, Saturniidae) caterpillar was performed using energy dispersive X-ray fluorescence and instrumental neutron activation analysis techniques. This caterpillar is poisonous and has the ability to cause fatal hemorrhagic effects in humans after contact. The need of this study is related to morphological changes (mainly size and color) observed in some caterpillars used for preparation of antilonomic serum (antivenom). The samples were classified as healthy (caterpillars of control) and unhealthy (caterpillars visibly modified). The XRF measurements were performed in an energy dispersive X-ray fluorescence spectrometer and the instrumental neutron activation analysis using the IEA-R1 nuclear reactor at IPEN. The results show significant differences for several elements (mainly, P, Cl, Ca, Ti, Mn, Fe, Ni, and Zn) in unhealthy caterpillars that can affect the development of this species as well as the quality and yield of the antivenom. Furthermore, its elemental characterization contributes for the understanding the potential pharmacological (procoagulant and antithrombotic) in the prevention of life-threatening blood clots

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.