Sex distinctions regarding serum zinc levels in critically ill COVID-19 patients.

PURPOSE: Men and women exhibit different presentations in COVID-19. In X chromosome, changes in zinc finger domains cause disorders of sex development. So, we aimed to evaluate sex distinctions regarding serum zinc in severe COVID-19. METHOD: Data from electronic records of severe COVID-19 patients were correlated with serum zinc. Logistic regression investigated predictors and protectors of hypozincemia in men and women. RESULTS: We assessed 188 medical records (men = 114, women = 74). In men, low zinc was correlated with hypertension (cc = 0.303, p < 0.001), diabetes (cc = 0.198, p = 0.031), hemoglobin (cc = -0.258, p = 0.005), and albumin (cc = -0.219, p = 0.027). Low lymphocyte count (cc = 0.315, p = 0.005), C-reactive protein (cc = -0.248, p = 0.037), and enteral nutrition (cc = 0.269, p = 0.016) were correlated with hypozincemia in women. Age correlated with low zinc in men (c = -0.304, p = 0.001) and women (cc = -0.298, p = 0.010). In men, hypertension (OR = 4.905, p = 0.005) and lymphopenia (OR = -0.999, p = 0.019) were low zinc predictors, while lung injury > 50% was a protective factor (OR = -0.280, p = 0.025). Lymphopenia (OR = -0.999, p = 0.005) and difficult weaning from mechanical ventilation (MV) (OR = 4.359, p = 0.036) were predictors of hypozincemia in women. Difficult weaning from MV (OR = 3.012, p = 0.003) and age (OR = 1.038, p = 0.002) were hypozincemia predictors regardless sex. CONCLUSION: Hypertension, diabetes, hemoglobin and albumin were correlated with low zinc in men. Lymphopenia, reactive-C protein and enteral nutrition were correlated with low zinc in women. In men, hypertension and low lymphocytes were predictors of hypozincemia. Lymphopenia and difficult weaning from MV were predictors of low zinc in women.

Decreased plasma iron levels in women with hyperglycemia are associated with inflammatory status and involve increased HbA1c, osmotic stability, and volume variability of red blood cells.

BACKGROUND AND AIMS: Iron deficiency tendency in individuals with hyperglycemia influences the HbA1c levels' ability to estimate the stationary blood glucose levels. This study investigated the associations of iron status indicators and HbA1c levels with anthropometric, inflammatory, regulatory, metabolic, and hematologic variables in women with hyperglycemia to most widely characterize this iron deficiency tendency. METHODS: A total of 143 volunteers (68 with normoglycemia and 75 with hyperglycemia) participated in this cross-sectional study. Mann-Whitney test was used to compare groups, and the search for associations between pairs of variables used the Spearman correlation method. RESULTS: In women with hyperglycemia, decreased plasma iron level is associated directly with increased HbA1c (p < 0.001), and these changes are both related to C-reactive protein elevation (p = 0.02 and p < 0.05, respectively) and involve decreased mean hemoglobin concentration (p < 0.01 and p < 0.01), which in turn, involves enhanced osmotic stability (dX) (p < 0.05) and volume variability (RDW) (p < 0.0001) of erythrocytes, as well as decreased indirect bilirubin/total bilirubin ratio (p = 0.04). This indirect bilirubin/total bilirubin decrease, which expresses decreased hemoglobin catabolism, does not seem to be solely a process associated with diminished intracellular concentrations of this protein (p = 0.04) since it is associated with CRP elevation (p = 0.03) and reduced LDL cholesterol (p < 0.0001). CONCLUSIONS: In women with hyperglycemia, decreased plasma iron levels were associated with inflammatory status and involved increased HbA1c, osmotic stability, and volume variability of red blood cells.

The effectiveness of automated digital health solutions at successfully managing obesity and obesity-associated disorders: A PICO-structured investigation.

Most adults in the UK and USA are classified as overweight or obese. Recent studies suggest that the prevalence of obesity has further increased during the SARS-CoV-2 pandemic and associated lockdowns. Digital technologies may be effective at managing obesity and related comorbidities, a potential further justified by social isolation and distancing circumstances. This review of published literature employed a Patient-Intervention-Comparison-Outcome structured approach on the use of digital solutions to determine the effectiveness of their use in the management and treatment of obesity, hypertension, and type 2 diabetes and included commercially available, automated devices and applications that did not require intervention from a clinician. Our search covered studies published between January 2004 and February 2019, and 18 papers were included in the final analysis. The digital solutions reviewed were smartphone applications, wearable activity trackers, and 'digital medicine offerings' (DMO), including ingestible sensors and wearable patches. This study found that not all interventions were effective at encouraging the lifestyle changes required for the management of obesity. Smartphone applications requiring interaction from the patient appeared to be more effective at encouraging engagement with treatment interventions than more passive wearable activity trackers. Automated feedback from smartphone applications was effective at managing type 2 diabetes, while DMO were effective at reducing blood pressure. With the advancement of new technologies alongside a rapid increase in the prevalence of obesity and associated disorders, further studies comparing the various technologies available in larger sample populations for longer periods would help determine the most cost-effective preventive and therapeutic strategies.

The usefulness of melatonin in the field of obstetrics and gynecology.

Disorders of the female reproductive system, including those associated with hormone regulation, fertility rate and fetal health, are issues of great concern worldwide. More recently, melatonin supplementation has been suggested as a therapeutic approach in gynecological practice. In both animal models and in women, melatonin supplementation suggests a therapeutic and preventative potential, effects attributed mainly to its antioxidant properties and action as hormone modulator. The aim of this literature review is to further investigate the evidence available on the effects of melatonin supplementation in animal and human studies, focusing on its potential application to gynecology. Melatonin-containing supplements are easily found in online and high street retailers, and despite its supplementation deemed to be relatively safe, no consensus has been reached on effective dosage and supplementation period. Short term supplementation studies, of up to six months, suggest that a daily posology of 2-18 mg of melatonin may have the potential to improve fertility rate, oocyte quality, maturation and number of embryos. However, the evidence available so far on the effects of melatonin supplementation covering gestational age and gestational outcomes is very scarce. Clinical trials and longer-term supplementation studies are required to assess any clinical outcome associated with melatonin supplementation in the field of gynecology.

The effect of artichoke on lipid profile: A review of possible mechanisms of action.

Cardiovascular disease is a highly prevalent issue worldwide, and one of its main manifestations, dyslipidaemia, needs more attention. Cooked artichoke (Cynara scolymus) hearts or artichoke leaf extract (ALE) are believed to be helpful in the treatment of dyslipidaemia. In this narrative review, we provide a brief overview of the potential impact of artichoke consumption on lipid profile. We appraised the Cochrane, MEDLINE and Web of Science databases, and included articles published between 2000 and June 2018 on intervention in humans only. The main potential of ALE administration observed on lipid profile relates to decreased serum LDL, total cholesterol and triglyceride concentrations, although no strong evidence for increasing HDL appears to exist. Evidence suggests that decreases of 8-49 mg/dL for LDL concentration, 12-55 mg/dL for total cholesterol, and 11-51 mg/dL for triglycerides, can be attributed to 2 to 3 g/d of ALE, in which its components luteolin and chlorogenic acid may play a key role. On the other hand, the effects of cooked artichoke hearts can be attributed mainly to its soluble fibres, particularly inulin. Despite the convincing evidence on its health benefits, additional long-term clinical trials are pivotal to fully elucidate the potential effects of ALE administration on positive cardiovascular outcomes.

Neutrophil-Lymphocyte ratio in cardiovascular disease risk assessment / Relação Neutrófilo-Linfócito na avaliação de risco de doença cardiovascular

The development of cardiovascular diseases with atherosclerotic origin is associated with a severe inflammatory process. Neutrophils and lymphocytes are cells sensitive to this type of disorder and their ratio, known as the NLR (neutrophil/lymphocyte ratio), has shown to be useful in clinical practice. The aim of this study was to assess the role of NLR in cardiovascular disease risk assessment. We carried out a literature review in the PubMed databases searching for articles published between 2001 to 2017 and found that NLR is in fact a useful marker for cardiovascular disease. Using NLR in patients at cardiovascular risk would be useful to delineate the prognosis of patients with this disease pattern