Circulating spexins in children with obesity: relation to cardiometabolic risk.

BACKGROUND/OBJECTIVES: The role of spexin (SPX) in energy metabolism, endocrinal homeostasis, and vasculopathy is emerging. However, scarce data are available about its role in childhood obesity and obesity-related vasculopathy. Hence, we aimed to assess the level of SPX in obese and normal-weight children, and to correlate it with aortic distensibility (AD) and aortic stiffness index (ASI). SUBJECTS/METHODS: Forty obese children were compared to 40 matched normal-weighed children. Weight, height, and body mass index (BMI) z score and mean blood pressure (Bl-Pr) percentile on three different occasions were obtained. SPX, fasting triglycerides, cholesterol, low-density (LDL), high-density lipoproteins (HDL), and insulin were measured with calculation of the homeostatic model assessment insulin resistance (HOMA-IR). Internal aortic diameter was measured with calculation of AD, strain (AS), and ASI. RESULTS: Children with obesity had significantly lower SPX (P = 0.004), HDL (P < 0.001), and AD (P < 0.001) and higher systolic Bl-Pr (P < 0.001), diastolic Bl-Pr (P < 0.001), LDL (P = 0.011), HOMA-IR (P < 0.001), and ASI (P < 0.001). Significant negative correlation was found between SPX and BMI z score (r = -0.646, P < 0.001), systolic Bl-Pr (r = -0.641, P < 0.001), diastolic Bl-Pr (r = -0.427, P < 0.001), HOMA-IR (r = -0.349, P = 0.028), and ASI (r = -0.389, P = 0.013), while significant positive correlation was found between SPX and AS (P < 0.001, r = 0.633) and AD (P < 0.001, r = 0.612). However, no significant correlation was found between SPX and age (r = -0.01, P = 0.953), TG (r = 0.048, P = 0.767), total cholesterol (r = -0.023, P = 0.887), LDL (r = -0.299, P = 0.061), and HDL (r = 0.193, P = 0.232). CONCLUSIONS: Children with obesity had significantly lower SPX than controls. SPX was correlated with BMI, Bl-Pr, HOMA-IR, and vasculopathy in children with obesity independent of their age and lipid profile. Further studies should explore the pathomechanism of SPX and its potential role in the management of obesity and obesity-related cardiometabolic risk.

The Possible Preventive Role of Pregabalin in Postmastectomy Pain Syndrome: A Double-Blinded Randomized Controlled Trial.

CONTEXT: Chronic postmastectomy pain syndrome (PMPS) has a considerable negative impact on the quality of life of breast cancer patients. OBJECTIVE: The objective of this study was to assess the possible preventive role of perioperative pregabalin in PMPS. METHODS: This randomized controlled study included 200 patients with breast cancer scheduled for elective breast cancer surgery. They were randomly assigned to one of two treatment groups. The pregabalin group received 75 mg of pregabalin twice daily for seven days and the control group received oral equivalent placebo capsules. The primary outcome was development of neuropathic PMPS. Neuropathic pain was assessed using the Grading System for Neuropathic Pain. Secondary outcome measures were safety and Visual Analogue Scale scores. RESULTS: Neuropathic pain was significantly less frequent in the pregabalin group compared to the control group at four weeks (P = 0.005), 12 weeks (P = 0.002), and 24 weeks (P < 0.001) postoperatively. PMPS was diagnosed in 11 patients (11%) of the pregabalin group and 29 patients (29%) of the control group (P < 0.001, relative risk: 0.26, 95% CI: 0.12-0.56). At the three follow-up time points, Visual Analogue Scale scores during the first three postoperative weeks were comparable in both groups while they were significantly lower in the pregabalin group at 4, 12, and 24 weeks. These two groups were comparable in the frequency of adverse events (P = 0.552). CONCLUSION: Perioperative oral pregabalin 75 mg twice daily, starting at the morning of surgery and continued for one week, could reduce the frequency of postmastectomy pain syndrome.

The impact of using chickpea flour and dried carp fish powder on pizza quality.

Pizza being the most popular food worldwide, quality and sensory appeal are important considerations during its modification effort. This study was aimed to evaluate the quality of pizza made using two different sources of proteins, chickpea (Cicer arietinum) flour and dried carp fish powder (Cyprinus carpio). Analysis indicated nutrients richness specificity of chickpea flour (higher fiber, energy, iron, zinc, linoleic acid and total nonessential amino acids) and dried carp fish powder (higher contents of protein, fats, ash, oleic acid and total essential amino acids) complementing wheat flour to enhance nutritional value of pizza. Total plate count and thiobarbituric acid were increased (P<0.05) in dried carp fish powder after 45 days of storage, but no Coliform were detected. Wheat flour was substituted with 5, 7.5 and 10% chickpea flour or dried carp fish powder and chemical, textural, sensory and storage evaluation parameters of in pizza were investigated. Dried carp fish powder increased (P<0.05) contents of protein, ash, fats, zinc and protein digestibility of pizza. Chickpea flour increased iron and zinc contents of the pizza. Water activity (aw) was decreased in fish powder and chickpea pizza. Pizza firmness and gumminess were significantly (p<0.05) increased at every level of protein source, but cohesiveness was decreased with 10% chickpea flour. Pizza chewiness was the same (P>0.05) across the levels of two protein sources. Springiness was decreased (P<0.05) with high level (10%) dried fish powder and low/intermediate level of chickpea flour. Chickpea and dried carp fish incorporation up to 7.50% in pizza at the expense of wheat flour had no effect (P>0.05) on all sensorial parameters except for odor values. The results could be useful in utilization of chickpea flour and carp fish powder in designing nutritious pizza for consumers.

Evaluation of vitamin D levels in allergic fungal sinusitis, chronic rhinosinusitis, and chronic rhinosinusitis with polyposis.

BACKGROUND: Vitamin D3 (VD3 ) levels have been recently found to be responsible for a number of immunological, anti-inflammatory and anti-infectious roles. Some studies reported that some forms of allergic fungal rhinosinusitis (AFRS), occurs more commonly in patients who are more susceptible to VD3 deficiency. The aim of this work was to measure VD3 levels in patients with AFRS and chronic rhinosinusitis (CRS). METHODS: We report a prospective case control study conducted at Ain Shams University. It included 74 participants divided into 4 groups: group A, 25 patients with AFRS; group B, 15 patients with CRS with nasal polyps (CRSwNP); group C: 15 patients with CRS without nasal polyps (CRSsNP); and group D, 19 controls. RESULTS: There was a statistically significant (p < 0.001) difference of VD3 between groups A and B compared with groups C and D. There were no statistically significant differences between the 4 groups regard calcium levels. Finally, there was a statistically significant difference in phosphate levels when we compared groups A and B with groups C and D (p = 0.001). CONCLUSION: Serum level of VD3 in patient with CRSwNP and AFRS is significantly lower than that of patients with CRSsNP and control subjects. Although these results do not imply a specific etiological or therapeutic relationship, VD3 levels may constitute an inexpensive prophylactic and cost-effective option in the therapeutic armamentarium in the control of AFRS and CRSwNP, either by itself or as a synergistic agent with traditional agents.

Intracoronary versus intravenous adenosine-induced maximal coronary hyperemia for fractional flow reserve measurements.

BACKGROUND: Maximal hyperemia is the critical prerequisite for fractional flow reserve (FFR) assessment. Despite intravenous (IV) adenosine currently being the recommended approach, intracoronary (IC) administration of adenosine constitutes a valuable alternative in everyday practice. However, it is surprisingly unclear which IC strategy allows the achievement of FFR values that are comparable to IV adenosine. OBJECTIVES: This study sought to compare increasing doses of IC adenosine versus IV adenosine for FFR. METHODS: 30 intermediate coronary stenoses undergoing FFR measurement were prospectively and consecutively enrolled. Hyperemia was sequentially induced by bolus of IC adenosine (ADN; 150 µg) followed by IV adenosine (IVADN) infusion over 3 minutes at dose of (140 µg/kg/min). FFR values, symptoms, and development of atrioventricular block were recorded. RESULTS: 150 µg doses of IC adenosine were well tolerated and associated with fewer symptoms than IV adenosine. Intracoronary adenosine doses induced a significant decrease of FFR compared with baseline levels (P < 0.01). Among the 6 patients with FFR values less than 0.80 identified by IVADN, 4 were correctly identified also by 150 µg bolus IC adenosine. Larger randomized studies with cross-over design are necessary to verify the results. CONCLUSIONS: This small pilot study suggests that IC adenosine might be an alternative to IV adenosine. Larger randomized studies with a cross-over design are necessary.

Protein solubility, digestibility and fractionation after germination of sorghum varieties.

The changes in crude protein, free amino acids, amino acid composition, protein solubility, protein fractionation and protein digestibility after germination of sorghum were investigated. Sorghum varieties (Dorado, Shandaweel-6, Giza-15) were soaked for 20 h followed by germination for 72 h; the results revealed that crude protein and free amino acids in raw sorghum varieties ranged from 10.62 to 12.46% and 0.66 to 1.03 mg/g, respectively. Shandaweel-6 was the highest variety in crude protein and free amino acids content. After germination, crude protein was decreased and free amino acids were increased. There was an increase in content of valine and phenylalanine amino acids after germination. On the other hand, there was a decrease in most of amino acids after germination. After germination protein solubility was significantly increased. Regarding protein fractions, there was an increase in albumin, globulin and kafirin proteins and a decrease in cross linked kafirin and cross linked glutelin after germination.

Biochemical changes in phenols, flavonoids, tannins, vitamin E, ß-carotene and antioxidant activity during soaking of three white sorghum varieties.

OBJECTIVE: To investigate the changes in total phenols, flavonoids, tannins, vitamin E, ß-carotene and antioxidant activity during soaking of three white sorghum varieties. METHODS: The changes in total phenols, total flavonoids, tannins, phenolic acids compounds, flavonoid components, vitamin E, ß-carotene and antioxidant activity during soaking of sorghum grains were determined. RESULTS: Total phenols, total flavonoids, tannins, vitamin E, ß-carotene and antioxidant activity in raw sorghum were ranged from 109.21 to 116.70, 45.91 to 54.69, 1.39 to 21.79 mg/100 g, 1.74 to 5.25, 0.54 to 1.19 mg/kg and 21.72% to 27.69% and 25.29% to 31.97%, respectively. The above measured compounds were significantly decreased after soaking. p-Hydroxybenzoic acid, vanillic acid, syringic acid and cinnamic acid represent the major phenolic acids in Dorado variety. While ferulic acid, p-coumaric acid, gallic acid and caffeic acid represent the major phenolic acids in Shandaweel-6. On the other hand, protocatechuic acid represents the major phenolic acids in Giza-15. Regarding flavonoids components, Dorado was the highest variety in kampferol and naringenin while Shandaweel-6 was the highest variety in luteolin, apigenin, hypersoid, quercetin and christen. Finally, Giza-15 was the highest variety in catechin. Phenolic acids, flavonoid compounds and antioxidant activities were decreased after soaking. CONCLUSIONS: Sorghum varieties have moderate quantities from total phenols, total flavonoids, tannins, phenolic acids compounds, flavonoid components, vitamin E, ß-carotene and antioxidant activity which decreased after soaking.

Bioavailability of iron, zinc, phytate and phytase activity during soaking and germination of white sorghum varieties.

The changes in phytate, phytase activity and in vitro bioavailability of iron and zinc during soaking and germination of three white sorghum varieties (Sorghum bicolor L. Moench), named Dorado, Shandweel-6, and Giza-15 were investigated. Sorghum varieties were soaked for 20 h and germinated for 72 h after soaking for 20 h to reduce phytate content and increase iron and zinc in vitro bioavailability. The results revealed that iron and zinc content was significantly reduced from 28.16 to 32.16% and 13.78 to 26.69% for soaking treatment and 38.43 to 39.18% and 21.80 to 31.27% for germination treatments, respectively. Phytate content was significantly reduced from 23.59 to 32.40% for soaking treatment and 24.92 to 35.27% for germination treatments, respectively. Phytase enzymes will be activated during drying in equal form in all varieties. The results proved that the main distinct point is the change of phytase activity as well as specific activity during different treatment which showed no significant differences between the varieties used. The in vitro bioavailability of iron and zinc were significantly improved as a result of soaking and germination treatments.

Fluoroscopic stellate ganglion block for postmastectomy pain: a comparison of the classic anterior approach and the oblique approach.

OBJECTIVE: Stellate ganglion block is usually performed with the classic anterior paratracheal approach. The anatomy of the stellate ganglion being in close proximity to various critical structures renders a number of complications, which are potentially associated with its blockade. The aim of this study was to assess the analgesic efficacy and safety of a new approach of the stellate ganglion block using an oblique fluoroscopic view. METHODS: Fifty patients with postmastectomy pain syndrome were randomly allocated into 1 of 2 groups: the anterior paratracheal stellate block group and the oblique fluoroscopic stellate block group. Four blocks were performed for each patient using the same approach each time. The results were evaluated in terms of pain intensity as assessed by the visual analog scale score, morphine consumption, and allodynia surface area (in cm). Patient satisfaction score (PSS), skin temperature, side effects, and complications were recorded and compared between the 2 studied groups after each block had been performed. RESULTS: The mean visual analog scale score, daily morphine consumption, and areas of allodynia were significantly decreased and the PSS was significantly increased after each block and for up to 3 months after the last block in both the groups. However, there were no statistically significant differences between the 2 groups at the same study period apart from PSS, which was statistically more significant in group oblique at certain times. The incidences of side effects were significantly more in group classic than in group oblique. CONCLUSIONS: The oblique fluoroscopic approach of the stellate ganglion block is as effective as the anterior paratracheal approach but is safer and more satisfactory to the patients.