Role of nutritional therapy on dietary habits and glycemic control in insulin-treated kidney transplant patients with diabetes.

AIMS: To evaluate the effect of nutritional therapy on glycemic compensation and key cardio-renal risk markers in patients with diabetes and kidney transplant, on insulin treatment by Multiple Daily Injection (MDI) or Continuous Subcutaneous Insulin Infusion (CSII). METHODS: 34 patients with diabetes on insulin treatment and kidney transplant recipients were enrolled;12 participated in the structured nutritional program (intervention group), 22 patients (control group) did not receive nutritional protocol. Both groups were then divided into subgroups according to the method of insulin administration (MDI and CSII). RESULTS: Statistically significant reduction in fasting blood glucose values, glycosylated hemoglobin (HbA1c) and glycosuria were observed in both groups at the end of the study. The intervention group, significantly reduced total cholesterolemia and the glycemic index, together with reduced dietary intake of lipids, cholesterol, soluble carbohydrates and increased consumption of carbohydrates and fiber. These improvements were even more pronounced in patients treated with CSII. CONCLUSIONS: A proper nutritional approach optimize glycometabolic outcomes and contribute significantly to the reduction of the major cardiovascular risk factors in renal transplant patients.

Evaluation of the effectiveness and safety of combined oral and topical photoprotection with a standardized extract of Polypodium leucotomos (Fernblock®) in a Moroccan population with xeroderma pigmentosum.

BACKGROUND: Xeroderma pigmentosum (XP) is a rare autosomal-recessive genodermatosis resulting from a DNA-repair defect syndrome. The purpose was to evaluate the prevention on new malignant lesions in patients taking a supplement with Fernblock® (Polypodium leucotomos extract [PLE]) and secondarily correlation with the photoprotective behavior. METHODS: A prospective, single-center and open cohort study was conducted over a 12-month period. The study was performed in Morocco. Optimal photoprotection behavior was recommended. Patients were instructed to take one capsule containing 480 mg of Fernblock® and 5 mcg vitamin D and to apply sunscreen with a SPF50+ and Fernblock® every 2 h during sun exposure. The demographic, clinical, and dermatoscopic patient data were collected at baseline (T0) and following visits at 3 months (T3), 6 months (T6), and 12 months (T12) when it was assessed: Investigator Global Assessment (IGA), Patient/Guardian Global Assessment (PGA), Patient/Guardian Satisfaction Questionnaire, and Photographic and Adverse Events Registration. Pertinent statistical study was performed. RESULTS: Eighteen patients completed the study. Eleven patients (61%) finished the study without new lesions. Seven patients developed new lesions by the end of the study. Among them, only 30% showed an ideal photoprotective behavior. The lack of an optimal photoprotective behavior increased the probability of developing lesions by 2.5 times with 95% confidence interval. CONCLUSIONS: In our study, more than 60% of patients taking a supplement with Fernblock® did not develop new lesions, and furthermore, we detected that patients following almost ideal photoprotection were 2.5 times less likely to develop NMSC lesions.

Comparative analysis of Laser and LED phototherapies pain control after insertion of elastomeric separators in orthodontics patients: Clinical trial.

The aim of this study was to evaluate the effectiveness of pain modulation following Laser or LED phototherapies during the process of tooth separation. This was a longitudinal randomized controlled clinical trial in four observational times carried out in 60 patients (15 males, 45 females, average 24.1 years old) who were randomly divided into three groups: G1 (LED, AsGaAl, λ850 ± 10 nm, 150 mW, 17 J/cm2, 57 s per session), G2 (Laser, AsGaAl, λ780 nm, 70 mW, 20.0 J/cm2, 240 s per session) and G3 (Non-irradiated Control). All patients were submitted to tooth separation using elastomeric separators. The pain level was measured by using a visual analogue scale (VAS) immediately after insertion (T1) of the elastic, at 48 (T2), 96 (T3) hours and 6 days (T4). It was observed an increase of the pain on the Control group from T1 to T2, with statistical significance. Pain levels in the LED and Laser groups were always significantly lower (<0.001), except for T1. According with the results of the present study it may be concluded that, either LED or Laser phototherapies, were effective in reducing the pain level after dental separation process when compared to the control group.

Single-agent anti-PD-1 or combined with ipilimumab in patients with mucosal melanoma: an international, retrospective, cohort study.

BACKGROUND: Mucosal melanoma (MM) is a rare melanoma subtype with distinct biology and poor prognosis. Data on the efficacy of immune checkpoint inhibitors (ICIs) are limited. We determined the efficacy of ICIs in MM, analyzed by primary site and ethnicity/race. PATIENTS AND METHODS: A retrospective cohort study from 25 cancer centers in Australia, Europe, USA and Asia was carried out. Patients with histologically confirmed MM were treated with anti-programmed cell death protein 1 (PD-1) ± ipilimumab. Primary endpoints were response rate (RR), progression-free survival (PFS), overall survival (OS) by primary site (naso-oral, urogenital, anorectal, other), ethnicity/race (Caucasian, Asian, Other) and treatment. Univariate and multivariate Cox proportional hazards model analyses were conducted. RESULTS: In total, 545 patients were included: 331 (63%) Caucasian, 176 (33%) Asian and 20 (4%) Other. Primary sites included 113 (21%) anorectal, 178 (32%) urogenital, 206 (38%) naso-oral and 45 (8%) other. Three hundred and forty-eight (64%) patients received anti-PD-1 and 197 (36%) anti-PD-1/ipilimumab. RR, PFS and OS did not differ by primary site, ethnicity/race or treatment. RR for naso-oral was numerically higher for anti-PD-1/ipilimumab [40%, 95% confidence interval (CI) 29% to 54%] compared with anti-PD-1 (29%, 95% CI 21% to 37%). Thirty-five percent of patients who initially responded progressed. The median duration of response (mDoR) was 26 months (95% CI 18 months-not reached). Factors associated with short PFS were Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥3 (P < 0.01), lactate dehydrogenase (LDH) more than the upper limit of normal (ULN) (P = 0.01), lung metastases (P < 0.01) and ≥1 previous treatments (P < 0.01). Factors associated with short OS were ECOG PS ≥1 (P < 0.01), LDH >ULN (P = 0.03), lung metastases (P < 0.01) and ≥1 previous treatments (P < 0.01). CONCLUSIONS: MM has poor prognosis. Treatment efficacy of anti-PD-1 ± ipilimumab was similar and did not differ by ethnicity/race. Naso-oral primaries had numerically higher response to anti-PD-1/ipilimumab, without difference in survival. The addition of ipilimumab did not show greater benefit over anti-PD-1 for other primary sites. In responders, mDoR was short and acquired resistance was common. Other factors, including site and number of metastases, were associated with survival.

Long-term effect of anticancer therapy on dentition of Italian children in remission from malignant disease: A cross-sectional study.

AIM: To investigate the effects of anticancer therapy on dental development and caries formation in Italian childhood cancer survivors compared to healthy controls. METHODS: A total of 52 children treated with chemotherapy and/or radiotherapy when younger than 10 years and in remission from at least 2 years, and 52 healthy age- and gender-matched children were consecutively enrolled in this cross-sectional study. All participants were examined for dental caries and enamel defects according to the decayed-missing-filled teeth (dmft/DMFT) index and the Aine rating scale. Panoramic radiographs were taken to estimate dental age and to assess dental abnormalities using the Höltta Defect Index. CONCLUSION: These children are at high risk for tooth developmental abnormalities and poor dental health and should be closely monitored by a specialist dentist.

Evaluation of the effectiveness of three sticky traps to monitor four species of cockroaches (Hexapoda: Blattaria) with simulated use tests.

Background: Cockroaches are the pest of major concern for the disinfestation programs of the sanitary system in Italy. Hygienic-sanitary interest is linked to the role of mechanical vectors of pathogens and to their allergological potential. Sticky traps are the best tool to monitor the presence of these insects and several types of them are available on the market. In most of the cases the traps are not indicated for a given species, but, instead, generically for cockroaches. Domestic cockroaches differ in morphology, size and habits. Consequently, the effectiveness of the trap can change in relation to the target species. Materials and methods: In this study three of the most employed traps in Italy were compared: the INDIA trap with and without its attractant tablet (hereafter mentioned as INDIA-A and INDIA-E, respectively), the ZAPI Simply trap and the CATCHMASTER Spider & Insect Glue trap. We chose the four most common species of cockroach (Blattodea) in Italy, Blatta orientalis (L.), Periplaneta americana (L.) (Blattidae), Blattella germanica (L.) and Supella longipalpa (F.) (Blattellidae). Each species of cockroach was tested separately inside arenas containing one of the traps. Each test (one species with one kind of trap) was replicated five times. Results and discussion: The INDIA-A trap collected more cockroaches of every species, followed by the INDIA-E. The ZAPI trap caught less specimens of each species in respect to the INDIA traps, with the only exception of B. orientalis, for which the ZAPI trap caught more than the INDIA-E. The CATCHMASTER trap performed significantly less for all the species. B. orientalis was the species most abundantly caught by all traps, followed by B. germanica, S. longipalpa and P. americana. No significant difference was observed in the catch according to the developmental stage. In general, there was no particular predisposition of any trap to catch a particular species. Conclusions: It is not possible to indicate a model of trap for each species of cockroach, but it is clear that different traps have different performances in terms of attractiveness and capture. Therefore, the choice of the trap affects the results of the monitoring, and as consequence, the evaluation of the infesting population of the pest.

Sleep problems in a sample of children with developmental disorders, before and during the COVID-19 pandemic. / Problemas del sueño en una muestra de niñas y niños con trastornos del desarrollo, antes y durante la pandemia por COVID-19.

INTRODUCTION: Sleep problems (SPs) are common, especially among children with developmental disorders (DDs), and affect their functioning and quality of family life. Pediatricians play a major role in their management. OBJECTIVE: To define the frequency and types of SPs in a sample of children with DDs, determine the proportion of pediatricians who addressed such difficulties, assess the effects of sleep hygiene (SH), and describe the impact of the COVID-19 pandemic on sleep. POPULATION AND METHODS: This was a quasiexperiment. SPs were diagnosed based on parents' concerns and/or clinical criteria. SH strategies were provided and their effect was assessed as per parents' reports and the Children's Sleep Habits Questionnaire in Spanish (CSHQ-S) before and after the strategies. During the COVID-19 pandemic, the SP outcome measure and SH-related outcome measures were measured again. RESULTS: A total of 161 children were included. The frequency of SPs was 55 %; 80 % improved with SH. Eighty-three percent of children had a primary pediatrician; of these, 45 % had consulted about sleep. During the COVID-19 pandemic, SPs increased and SH outcome measures changed. CONCLUSION: Approximately half of children with DDs have SPs; and the problem was only addressed by 45 % of pediatricians. SH was beneficial for most children, so pediatricians' role seems critical. During the COVID-19 pandemic, SPs increased, probably as a result of its environmental impact on children with DDs.

Los problemas del sueño (PS) son frecuentes, principalmente en niñas y niños con trastornos del desarrollo (TD), y causan un impacto en su funcionamiento y calidad de vida familiar. El pediatra tiene un rol importante en su abordaje. Objetivo. Definir la frecuencia y los tipos de PS en una muestra de niñas y niños con TD, determinar la proporción de pediatras que abordaron estas dificultades, evaluar los efectos de la higiene del sueño (HS) y describir el impacto de la pandemia por COVID-19 en el sueño. Población y métodos. Estudio cuasiexperimental. El diagnóstico de PS se realizó con la preocupación de los padres y/o criterios clínicos. Se brindaron estrategias de HS, luego se evaluó su efecto según referencia de los padres y uso del cuestionario CSHQ-S (Children´s Sleep Habits Questionnaire en español) pre- y posestrategias. Durante la pandemia por COVID-19, se midió nuevamente la variable PS y las relacionadas a HS. Resultados. Se incluyeron 161 niñas y niños. La frecuencia de PS fue del 55 %. El 80 % mejoró con HS. El 83 % tenía pediatra de cabecera, y de ellos, el 45 % había preguntado acerca del sueño. Durante la pandemia por COVID-19 hubo aumento de PS y cambios en las variables de HS. Conclusión. Aproximadamente la mitad de los niñas y niños con TD presentan PS; esto solo fue abordado por el 45 % de los pediatras. La HS resultó beneficiosa para la mayoría, por lo que la intervención del pediatra parece fundamental. Durante la pandemia por COVID-19 aumentaron los PS, como posible reflejo del impacto ambiental en los niñas y niños con TD.

Problemas del sueño en una muestra de niñas y niños con trastornos del desarrollo, antes y durante la pandemia por COVID-19 / Sleep problems in a sample of children with developmental disorders, before and during the COVID-19 pandemic

Los problemas del sueño (PS) son frecuentes, principalmente en niñas y niños con trastornos del desarrollo (TD), y causan un impacto en su funcionamiento y calidad de vida familiar. El pediatra tiene un rol importante en su abordaje. Objetivo. Definir la frecuencia y los tipos de PS en una muestra de niñas y niños con TD, determinar la proporción de pediatras que abordaron estas dificultades, evaluar los efectos de la higiene del sueño (HS) y describir el impacto de la pandemia por COVID-19 en el sueño. Población y métodos. Estudio cuasiexperimental. El diagnóstico de PS se realizó con la preocupación de los padres y/o criterios clínicos. Se brindaron estrategias de HS, luego se evaluó su efecto según referencia de los padres y uso del cuestionario CSHQ-S (Children ́s Sleep Habits Questionnaire en español) pre- y posestrategias. Durante la pandemia por COVID-19, se midió nuevamente la variable PS y las relacionadas a HS. Resultados. Se incluyeron 161 niñas y niños. La frecuencia de PS fue del 55 %. El 80 % mejoró con HS. El 83 % tenía pediatra de cabecera, y de ellos, el 45 % había preguntado acerca del sueño. Durante la pandemia por COVID-19 hubo aumento de PS y cambios en las variables de HS. Conclusión. Aproximadamente la mitad de los niñas y niños con TD presentan PS; esto solo fue abordado por el 45 % de los pediatras. La HS resultó beneficiosa para la mayoría, por lo que la intervención del pediatra parece fundamental. Durante la pandemia por COVID-19 aumentaron los PS, como posible reflejo del impacto ambiental en los niñas y niños con TD.

Sleep problems (SPs) are common, especially among children with developmental disorders (DDs), and affect their functioning and quality of family life. Pediatricians play a major role in their management. Objective. To define the frequency and types of SPs in a sample of children with DDs, determine the proportion of pediatricians who addressed such difficulties, assess the effects of sleep hygiene (SH), and describe the impact of the COVID-19 pandemic on sleep. Population and methods. This was a quasi-experiment. SPs were diagnosed based on parents' concerns and/or clinical criteria. SH strategies were provided and their effect was assessed as per parents' reports and the Children's Sleep Habits Questionnaire in Spanish (CSHQ-S) before and after the strategies. During the COVID-19 pandemic, the SP outcome measure and SH-related outcome measures were measured again. Results. A total of 161 children were included. The frequency of SPs was 55 %; 80 % improved with SH. Eighty-three percent of children had a primary pediatrician; of these, 45 % had consulted about sleep. During the COVID-19 pandemic, SPs increased and SH outcome measures changed. Conclusion. Approximately half of children with DDs have SPs; and the problem was only addressed by 45 % of pediatricians. SH was beneficial for most children, so pediatricians' role seems critical. During the COVID-19 pandemic, SPs increased, probably as a result of its environmental impact on children with DD

Evolución del neurodesarrollo con el uso del cuestionario de edades y etapas ASQ-3 en el control de salud de niños / Neurodevelopmental development with the use of the Ages and Stages Questionnaire (ASQ-3) in monitoring children’s health

Introducción: El desarrollo madurativo del niño es un aspecto esencial en el control periódico de la salud. El pediatra realiza una valoración integral del desarrollo, reconociendo factores de riesgo, e investiga sus alteraciones de forma sistemática, para intervenir en forma temprana y oportuna. Objetivo: Valorar la evolución con la detección e intervención temprana y sistemática mediante el control de la salud. Sujetos y métodos. Se realizó un estudio prospectivo que incluyó a 415 niños de 0 a 60 meses. Se completó el seguimiento longitudinal de 188 niños en los que se habían encontrado una o más áreas del neurodesarrollo afectadas. Se analizaron las derivaciones realizadas, la adhesión a las indicaciones médicas y la evolución clínica, y se repitió trimestralmente durante un año la misma prueba de detección con el Ages and Stages Questionnaire, tercera edición (ASQ-3). Resultados: Del total de la muestra inicial se encontró a 188 niños en riesgo (45%), de los cuales sólo 24 (7%) persistieron con el trastorno del neurodesarrollo en la muestra final. La comunicación resultó ser el área más afectada, tanto en la primera como en la segunda prueba. Se encontró a su vez una mayor prevalencia de adversidad socioambiental en los pacientes que presentaban retraso en la adquisición de una o más pautas madurativas y menor recuperación con las indicaciones de estimulación temprana. Conclusión: La detección y la intervención temprana en el neurodesarrollo permiten la mejoría en el 83% de los niños en el ámbito del control de salud desde la prevención

Introduction: A child's maturational development is an essential aspect in periodic health check-ups. The paediatrician carries out a comprehensive assessment of the child’s development, identifying risk factors and systematically investigates any alterations so as to be able to intervene in an early and timely manner. Aim. To assess development with early and systematic detection and intervention by means of health check-ups. Subjects and methods: A prospective study involving 415 children aged 0-60 months was conducted. A longitudinal follow-up was completed for 188 children in whom one or more areas of neurodevelopment had been found to be affected. Referrals, adherence to medical indications and clinical progress were analysed, and the same screening test was repeated one year later with the Ages and Stages Questionnaire, third edition (ASQ-3). Results: Of the total initial sample, 188 children were found to be at risk (45%), of whom only 24 (7%) continued with the neurodevelopmental disorder in the final sample. Communication proved to be the most affected area in both the first and the second tests. A higher prevalence of socio-environmental adversity was also found in patients who presented delayed acquisition of one or more maturational patterns and less recovery with early stimulation indications. Conclusion: Early detection and intervention in neurodevelopment allows 83% of children to undergo improvements in the field of prevention-based health monitoring

[Neurodevelopmental development with the use of the Ages and Stages Questionnaire (ASQ-3) in monitoring children's health]. / Evolución del neurodesarrollo con el uso del cuestionario de edades y etapas ASQ-3 en el control de salud de niños.

INTRODUCTION: A child's maturational development is an essential aspect in periodic health check-ups. The paediatrician carries out a comprehensive assessment of the child's development, identifying risk factors and systematically investigates any alterations so as to be able to intervene in an early and timely manner. AIM: To assess development with early and systematic detection and intervention by means of health check-ups. SUBJECTS AND METHODS: A prospective study involving 415 children aged 0-60 months was conducted. A longitudinal follow-up was completed for 188 children in whom one or more areas of neurodevelopment had been found to be affected. Referrals, adherence to medical indications and clinical progress were analysed, and the same screening test was repeated one year later with the Ages and Stages Questionnaire, third edition (ASQ-3). RESULTS: Of the total initial sample, 188 children were found to be at risk (45%), of whom only 24 (7%) continued with the neurodevelopmental disorder in the final sample. Communication proved to be the most affected area in both the first and the second tests. A higher prevalence of socio-environmental adversity was also found in patients who presented delayed acquisition of one or more maturational patterns and less recovery with early stimulation indications. CONCLUSION: Early detection and intervention in neurodevelopment allows 83% of children to undergo improvements in the field of prevention-based health monitoring.

TITLE: Evolución del neurodesarrollo con el uso del cuestionario de edades y etapas ASQ-3 en el control de salud de niños.Introducción. El desarrollo madurativo del niño es un aspecto esencial en el control periódico de la salud. El pediatra realiza una valoración integral del desarrollo, reconociendo factores de riesgo, e investiga sus alteraciones de forma sistemática, para intervenir en forma temprana y oportuna. Objetivo. Valorar la evolución con la detección e intervención temprana y sistemática mediante el control de la salud. Sujetos y métodos. Se realizó un estudio prospectivo que incluyó a 415 niños de 0 a 60 meses. Se completó el seguimiento longitudinal de 188 niños en los que se habían encontrado una o más áreas del neurodesarrollo afectadas. Se analizaron las derivaciones realizadas, la adhesión a las indicaciones médicas y la evolución clínica, y se repitió trimestralmente durante un año la misma prueba de detección con el Ages and Stages Questionnaire, tercera edición (ASQ-3). Resultados. Del total de la muestra inicial se encontró a 188 niños en riesgo (45%), de los cuales sólo 24 (7%) persistieron con el trastorno del neurodesarrollo en la muestra final. La comunicación resultó ser el área más afectada, tanto en la primera como en la segunda prueba. Se encontró a su vez una mayor prevalencia de adversidad socioambiental en los pacientes que presentaban retraso en la adquisición de una o más pautas madurativas y menor recuperación con las indicaciones de estimulación temprana. Conclusión. La detección y la intervención temprana en el neurodesarrollo permiten la mejoría en el 83% de los niños en el ámbito del control de salud desde la prevención.

Paediatric Orthodontics. Part 4: SEC III protocol in Class III malocclusion.

SEC III protocol: Early treatment of dentoskeletal Class III malocclusions. The early treatment of dentoskeletal Class III malocclusion is one of the more challenging situations for orthodontists, mainly for the uncertainty of stable long-term results due to the interaction of both environmental and genetic aetiological factors. Several interceptive protocols have been proposed during the past decades. The SEC III protocol includes two occlusal acrylic Splints combined with Class III elastics and chin cup. The protocol was proposed to facilitate Class III dentoskeletal correction by eliminating the intercuspation and the tongue thrust with clockwise mandibular rotation and minimal dentoalveolar compensation. The main difference with all the other appliances is the vertical control, which is crucial in difficult cases such as hyperdivergent Class III malocclusions.

Decision-making process as guide to the management of non-carious cervical lesions with and without painful symptomatology.

The aim of this study is to develop a decision-making path for the management of non-carious cervical lesions (NCCLs) associated with or without dentin hypersensitivity (DH) This will allow to limit or delay invasive approaches identifying the causes that produced them. The need for this review is because there are no clear guidelines in the current literature for the treatment of NCCLs. Usually, the selection of the best therapy option is postponed to clinical judgment which can be influenced by a patient's demands (aesthetic, symptomatologic reasons or worsening of pre-existing NCCL). To establish a therapeutic plan the young dentist should be able to distinguish the NCCLs that need to be monitored over time from those in need of early treatment. Indeed, the experience of the dentist and the compliance of the patient play a decisive role for the success of the therapy.

Can innovations in traditional pork products help thriving EU untapped pig breeds? A non-hypothetical discrete choice experiment with hedonic evaluation.

The EU is supporting measures that stimulate enhanced value-added products in order to conserve local and threatened livestock breeds. Several Traditional Pork Products (TPP) and Innovative Traditional Pork Products (ITPP) with health innovations from four untapped pig breeds in Spain (Porc Negre Mallorquí), Croatia (Turopolje), Italy (Cinta Senese) and Slovenia (Krskopolje) were analysed. Consumers' "Non-hypothetical" willingness to pay (WTP) and hedonic evaluation were investigated. An integrated experimental approach using two Non-Hypothetical Discrete Choice Experiment (NH-DCE) was carried out before and after a hedonic evaluation test. Results showed that the health innovative products (ITPP) received similar and even lower WTP than the "control" products (TPP) from the untapped pig breeds. The TPP outperformed products enriched with healthy ingredients or with reduced undesirable compounds. The potential demand for traditional and "unaltered" product from the rustic pig breeds could contribute to their conservation. A market niche exists, where consumers appreciate these high-quality products and where no "add-ons" are required to enhance their uptake.

Grape pomace polyphenols improve insulin response to a standard meal in healthy individuals: A pilot study.

BACKGROUND & AIMS: Dietary polyphenols have beneficial effects on glucose/lipid metabolism in subjects at high risk to develop type 2 diabetes; however, the underlying mechanisms are not clear. We aimed to evaluate: 1) the acute effects of the consumption of a drink rich in polyphenols from red grape pomace (RGPD) on glucose/insulin and triglyceride responses to a standard meal in healthy individuals, and, 2) the relationship between plasma levels of phenolic metabolites and metabolic parameters. METHODS: Twelve healthy men, aged 20-40 years participated in a randomized, controlled study according to a cross-over design. After a 3-day low-polyphenol diet, all participants consumed, on two different days and separated by a one week interval, after an overnight fast, a drink rich in polyphenols (1.562 g gallic acid equivalents (GAE)) or a control drink (CD, no polyphenols), followed after 3 h by a standard meal (960 kcal, 18% protein, 30% fat, 52% CHO). Blood samples were taken at fasting, 3 h after the drink, over 5 h after the standard meal and at fasting on the next day to measure plasma concentrations of glucose, insulin, triglyceride and phenolic metabolites. RESULTS: Glycemic and triglyceride post-meal responses were similar after both the RGPD and the control drink. In contrast, postprandial insulin incremental area (iAUC0-5h) was 31% lower (p < 0.05), insulin secretion index was 18% lower (p < 0.016) and insulin sensitivity (SI) index was 36% higher (p = 0.037) after the RGPD compared to CD. Among phenolic metabolites, gallic acid correlated inversely with the insulin response (r = -0.604; p = 0.032) and positively with the SI index (r = 0.588, p = 0.037). CONCLUSIONS: RGPD consumption acutely reduced postprandial insulin levels and improved insulin sensitivity. This effect could be likely related to the increase in gallic acid levels. This drink, added to usual diet, could contribute to increase the daily intake of polyphenols, with potential health benefits. CLINICALTRIALS. GOV IDENTIFIER: NCT02865278.

Claimed effects, outcome variables and methods of measurement for health claims proposed under regulation (EC) 1924/2006 and related to cognitive function in adults.

Some food/food components have been the object of request of authorization to the use of health claims related to cognitive function in adults and compliant with the Regulation (EC) 1924/2006. Most of the requests have received a negative opinion by the European Food Safety Authority (EFSA) also because of the choice of not appropriate outcome variables (OVs) and methods of measurement (MMs) selected in the trials used to substantiate the claim. This manuscript referes to the collection, collation and critical analysis of OVs and MMs related to cognitive function in adults. OVs and MMs were collected from the EFSA Guidance document and the applications for authorization of health claims pursuant to the Articles 13(5). The critical analysis of OVs and MMs, performed by a literature review, was aimed at defining their appropriateness in the context of a specific claimed effect. The results highlight the importance of an adequate choice of OVs and MMs for an effective substantiation of the claims related to cognitive functioning. The information provided in this document may serve to EFSA for updating the guidance on the scientific requirements for health claims related to cognitive functions, but also for a better design of randomized controlled trials aimed at substantiating such health claims.

Is laser conditioning a valid alternative to conventional etching for aesthetic brackets?

AIM: ER:Yag lasers have been described as a more conservative alternative to conventional acid-etching enamel conditioning technique, when bonding conventional metallic orthodontic brackets. Since the use of aesthetic orthodontic brackets is constantly increasing, the purpose of the present report has been to test laser conditioning with different aesthetic brackets. MATERIALS AND METHODS: Study Design: Five different aesthetic brackets (microfilled copolymer, glass fiber, sapphire, polyoxymethylene and sintered ceramic) were tested for shear bond strength and Adhesive Remnant Index scores using two different enamel conditioning techniques (acid etching and ER:Yag laser application). Two hundred bovine incisors were extracted, cleaned and embedded in resin. Specimens were then divided into 10 groups with random tables. Half of the specimens were conditioned with conventional orthophosphoric acid gel, the other half with ER:Yag laser. Different aesthetic brackets (microfilled copolymer, glass fiber, sapphire, polyoxymethylene and sintered ceramic) were then bonded to the teeth. Subsequently all groups were tested in shear mode with a Universal Testing Machine. Shear bond strength values and adhesive remnant index scores were recorded. Statistical analysis was performed. RESULTS: When considering conventional acid etching technique, sapphire, polyoxymethylene and sintered ceramic brackets exhibited the highest SBS values. Lowest values were reported for microfilled copolymer and glass fiber appliances. A significant decrease in SBS values after laser conditioning was reported for sapphire, polyoxymethylene and sintered ceramic brackets, whereas no significant difference was reported for microfilled copolymer and glass fiber brackets. Significant differences in ARI scores were also reported. CONCLUSIONS: Laser etching can significantly reduce bonding efficacy of sapphire, polyoxymethylene and sintered ceramic brackets.

Molecular epidemiology of Mycobacterium tuberculosis complex strains isolated from livestock and wild animals in Italy suggests the need for a different eradication strategy for bovine tuberculosis.

Bovine tuberculosis (bTB) is an important zoonosis, which has been re-emerging in different ecological scenarios. In Sicily, Italy, from 2004 to 2014, an anatomopathological survey for tuberculosis-like lesions both in farmed and wild animals was performed. The isolates were genotyped using spoligotyping and Mycobacterial Interspersed Repetitive Units-Variable Number of Tandem Repeats (MIRU-VNTR) techniques. High prevalence of lesions was observed for cattle (4%), pigs (4.9%) and wild boars (6.8%), and a total of 625 Mycobacterium bovis isolates were identified. Genotyping analysis showed the presence of 37 different spoligotypes including fifteen spoligotypes not present in other Italian regions and 266 MIRU-VNTR profiles. Spoligotype SB0120 exhibited the highest prevalence in cattle (50%) and pigs (56%) and the highest genetic variety with 126 different MIRU-VNTR profiles. The isolation of M. bovis in a farmer underlines the importance of M. bovis identification during the human TB diagnostic processes. This study supported the use of the genotyping analysis as a valuable tool for the evaluation of the epidemiological role of pigs and other domestic reservoirs such as goats and the role of wildlife in the maintenance of bTB infection.

Dietary intake and major food sources of polyphenols in people with type 2 diabetes: The TOSCA.IT Study.

PURPOSE: Proper evaluation of polyphenols intake at the population level is a necessary step in order to establish possible associations with health outcomes. Available data are limited, and so far no study has been performed in people with diabetes. The aim of this work was to document the intake of polyphenols and their major food sources in a cohort of people with type 2 diabetes and in socio-demographic subgroups. METHODS: We studied 2573 men and women aged 50-75 years. Among others, anthropometry was measured by standard protocol and dietary habits were investigated by food frequency questionnaire (EPIC). The intake of polyphenols was evaluated using US Department of Agriculture and Phenol-Explorer databases. RESULTS: The mean total polyphenol intake was 683.3 ± 5.8 mg/day. Non-alcoholic beverages represented the main food source of dietary polyphenols and provided 35.5% of total polyphenol intake, followed by fruits (23.0%), alcoholic beverages (14.0%), vegetables (12.4%), cereal products and tubers (4.6%), legumes (3.7%) and oils (2.1%); chocolate, cakes and nuts are negligible sources of polyphenols in this cohort. The two most important polyphenol classes contributing to the total intake were flavonoids (47.5%) and phenolic acids (47.4%). Polyphenol intake increased with age and education level and decreased with BMI; furthermore, in the northern regions of Italy, the polyphenol intake was slightly, but significantly higher than in the central or southern regions. CONCLUSIONS: The study documents for the first time the intake of polyphenols and their main food sources in people with diabetes using validated and complete databases of the polyphenol content of food. Compared with published data, collected in people without diabetes, these results suggest a lower intake and a different pattern of intake in people with diabetes.