The effects of dietary iodine content, milking system, and farming practices on milk iodine concentration and quality traits.

Various management practices can influence milk quality traits in dairy cattle. As an example, an increasing investment in automatic milking system to substitute milking parlors has been observed in the last 2 decades in dairy farms which could have affected certain bulk milk quality traits. What is more, milking practices can also affect certain milk parameters; as an example, teat disinfectants containing I are used in commercial farms where pre- or postdipping is performed, leading to presence of some I in the bulk milk. However, this trace mineral is also supplied in cows' diet to fulfill their nutritional requirements, partly contributing to the milk I final concentration. Therefore, the aim of this study was to evaluate the sources of variation of milk I along with other traditional milk quality traits. A total of 91 dairy farms in northeastern Italy were enrolled in the study. In each farm, diet and bulk milk samples were collected on the same day for chemical analysis. Concentration of I, in particular, was determined in both milk and feed with gold standard. Pearson correlations were calculated among the traits available for milk and diet, and a general linear model was used to test significance of fixed effects (feeding system, milking system, farming system, herd size, herd stage of lactation, and sampling month) on milk quality traits including the I concentration. In the case of milk I, diet I and presence of I-based predipping and postdipping teat disinfect application were also tested as fixed effects. Results showed a positive linear correlation between milk and diet I content (correlation coefficient [r] = 0.78). Although milk I was also positively correlated with lactose content (r = 0.25), dietary I was not correlated with other milk traits. Milk I content was significantly affected by dietary I, I-based predipping teat disinfectant application, and herd composition. Compared with conventional farms, organic farms showed lower protein content and greater somatic cell score (SCS) but similar milk I. Milking system significantly affected only lactose content and SCS of milk. Sampling month was only significant for milk urea nitrogen and herd composition, feeding system, herd size, and herd average days in milk did not modify milk gross composition and SCS. In conclusion, dietary supply of I is the main factor affecting milk I concentration and findings suggest that I level in milk can be naturally improved in dairy cows by modulating the I content in the diet administered. However, further research is needed to evaluate the effect of I-based sanitizers on milk I.

Application of a short-wave pocket-sized near-infrared spectrophotometer to predict milk quality traits.

Portable handheld devices based on near-infrared (NIR) technology have improved and are gaining popularity, even if their implementation in milk has been barely evaluated. Thus, the aim of the present study was to assess the feasibility of using short-wave pocket-sized NIR devices to predict milk quality. A total of 331 individual milk samples from different cow breeds and herds were collected in 2 consecutive days for chemical determination and spectral collection by using 2 pocket-sized NIR spectrophotometers working in the range of 740 to 1,070 nm. The reference data were matched with the corresponding spectrum and modified partial least squares regression models were developed. A 5-fold cross-validation was applied to evaluate individual device performance and an external validation with 25% of the dataset as the validation set was applied for the final models. Results revealed that both devices' absorbance was highly correlated but greater for instrument A than B. Thus, the final models were built by averaging the spectra from both devices for each sample. The fat content prediction model was adequate for quality control with a coefficient of determination (R2ExV) and a residual predictive deviation (RPDExV) in external validation of 0.93 and 3.73, respectively. Protein and casein content as well as fat-to-protein ratio prediction models might be used for a rough screening (R2ExV >0.70; RPDExV >1.73). However, poor prediction models were obtained for all the other traits with an R2ExV between 0.43 (urea) and 0.03 (SCC), and a RPDExV between 1.18 (urea) and 0.22 (SCC). In conclusion, short-wave portable handheld NIR devices accurately predicted milk fat content, and protein, casein, and fat-to-protein ratio might be applied for rough screening. It seems that there is not enough information in this NIR region to develop adequate prediction models for lactose, SCC, urea, and freezing point.

Correlation between epicardial fat thickness with intima-media thickness and ankle-brachial index in patients with metabolic syndrome.

Background An increase in epicardial fat thickness (EFT) has been associated with increased cardiovascular risk and the development of atherosclerosis. Transthoracic echo-cardiography provides a reliable measurement of EFT. We evaluated the relationship of EFT with carotid intima-media thickness (CIMT) and ankle-brachial index (ABI), in patients with metabolic syndrome. Methods We assessed 80 patients with metabolic syndrome who underwent echocardiography; EFT was measured by two cardiologists. The CIMT (B-mode colour imaging of extracranial carotid arteries using high-resolution ultrasound) was also measured by a certified ultrasonographer, and ABI was measured by the main researcher. Results We did not find any correlation between ABI with EFT (r=0.0103, p=0.93) or with CIMT (r=-0.1625, p=0.15). However, we found a significant correlation between EFT and CIMT (r=0.2718, r2=0.074, p=0.015). When we evaluated the risk for a CIMT >0.9 mm in patients with an EFT >3 mm, we found a statistically significant association (p=0.039). Interestingly, only 1 patient with an EFT <3 mm had a CIMT >0.9 mm. Conclusion We found that the EFT correlates with CIMT in patients with metabolic syndrome, which explains, at least in part, the higher risk of atherosclerosis in them. Measurement of EFT should be part of the cardiovascular risk evaluation in patients with metabolic syndrome.

Acute responses of muscle oxygen saturation during different cluster training configurations in resistance-trained individuals.

This study compared the perceptual responses, physiological indicators and technical parameters between different training protocols focused on upper body exercises. A randomized crossover design was performed, and 12 trained individuals (age: 27.1 ± 5.7 years; height: 173.7 ± 10.7 cm; BMI: 23.9 ± 2.3) completed three resistance training sessions under different protocols separated by at least 72 h: traditional training (TT) (4 x 6 repetitions at 85% of 1RM with 120 s of rest between sets), cluster 1 (CL1) (4 x 2+2+2 repetitions at 85% of 1RM with 15 s of intra-rep rest and 80 s between sets), and cluster 2 (CL2) (24 repetitions at 85% of 1RM with 15 s of inter-set recovery). Before training, arterial blood pressure (BP) and repetitions to failure of pull-up and push-up (FT) were collected. Muscle oxygen saturation (SmO2) in the chest and movement velocity were evaluated in barbell bench press during the training session. After finishing, lactate, BP, rate of perceived exertion and FT were assessed. The percentage of velocity loss (TT: 19.24%; CL1: 5.02% and CL2: 7.30%) in the bench press and lactate concentration (TT: 8.90 mmol·l-1; CL1: 6.13 mmol·l-1 and CL2: 5.48 mmol·l-1) were significantly higher (p < 0.05) for TT compared to both CLs. RPE values were higher (p < 0.05) in TT compared to CL1 (7.95 a.u. vs. 6.91 a.u., respectively). No differences (p > 0.05) were found between protocols for SmO2, BP, FT, pain or heart rate between set configurations. Cluster configurations allow one to maintain higher movement velocity and lower lactate and RPE values compared to a traditional configuration, but with similar concentrations of SmO2.

Improving fMRI in signal drop-out regions at 7 T by using tailored radio-frequency pulses: application to the ventral occipito-temporal cortex.

OBJECTIVE: Signal drop-off occurs in echo-planar imaging in inferior brain areas due to field gradients from susceptibility differences between air and tissue. Tailored-RF pulses based on a hyperbolic secant (HS) have been shown to partially recover signal at 3 T, but have not been tested at higher fields. MATERIALS AND METHODS: The aim of this study was to compare the performance of an optimized tailored-RF gradient-echo echo-planar imaging (TRF GRE-EPI) sequence with standard GRE-EPI at 7 T, in a passive viewing of faces or objects fMRI paradigm in healthy subjects. RESULTS: Increased temporal-SNR (tSNR) was observed in the middle and inferior temporal lobes and orbitofrontal cortex of all subjects scanned, but elsewhere tSNR decreased relative to the standard acquisition. In the TRF GRE-EPI, increased functional signal was observed in the fusiform, lateral occipital cortex, and occipital pole, regions known to be part of the visual pathway involved in face-object perception. CONCLUSION: This work highlights the potential of TRF approaches at 7 T. Paired with a reversed-gradient distortion correction to compensate for in-plane susceptibility gradients, it provides an improved acquisition strategy for future neurocognitive studies at ultra-high field imaging in areas suffering from static magnetic field inhomogeneities.

Low Effectiveness of Mid-Infrared Spectroscopy Prediction Models of Mediterranean Italian Buffalo Bulk Milk Coagulation Traits.

This study evaluated the potential use of mid-infrared spectroscopy to predict milk coagulation traits in bulk milk from Mediterranean Italian buffaloes. A total of 1736 bulk milk samples from 55 farms in central Italy were collected during the official milk quality testing system. The prediction models were developed based on modified partial least-squares regression with 75% of the samples and validated with the remaining samples. All bulk milk samples coagulated between 7.37 and 29.45 min. Average values for milk coagulation traits in the calibration set were 17.71 min, 3.29 min, and 38.83 mm for rennet coagulation time, curd firming time, and curd firmness, respectively. The validation set included samples with similar mean and standard deviation for each trait. The prediction models showed the greatest coefficient of determination of external validation (0.57) and the ratio of prediction to deviation (1.52) for curd firmness. Similar fitting statistics of the prediction models were obtained for rennet coagulation time and curd firming time. In conclusion, the prediction models for all three coagulation traits were below the threshold to consider the prediction models adequate even for rough screening of the samples.

Few-seconds range verification with short-lived positron emitters in carbon ion therapy.

In-beam PET (Positron Emission Tomography) is one of the most precise techniques for in-vivo range monitoring in hadron therapy. Our objective was to demonstrate the feasibility of a short irradiation run for range verification before a carbon-ion treatment. To do so a PMMA target was irradiated with a 220 MeV/u carbon-ion beam and annihilation coincidences from short-lived positron emitters were acquired after irradiations lasting 0.6 s. The experiments were performed at the synchrotron-based facility CNAO (Italian National Center of Oncological Hadrontherapy) by using the INSIDE in-beam PET detector. The results show that, with 3·107 carbon ions, the reconstructed positron emitting nuclei distribution is in good agreement with the predictions of a detailed FLUKA Monte Carlo study. Moreover, the radio-nuclei production is sufficiently abundant to determine the average ion beam range with a σ of 1 mm with a 6 s measurement of the activity distribution. Since the data were acquired when the beam was off, the proposed rapid calibration method can be applied to hadron beams extracted from accelerators with very different time structures.

Cold exposure increases intestinal paracellular permeability to nutrients in the mouse.

In situations of increased energy demand and food intake, animals can often acclimate within several days. The intestine generally responds to elevated digestive demand by increasing in size. However, there is likely a limit to how quickly the intestine can grow to meet the new demand. We investigated the immediate and longer-term changes to intestinal properties of the mouse when suddenly exposed to 4°C. We hypothesized that paracellular permeability to nutrients would increase as part of an immediate response to elevated absorptive demand. We measured absorption of l-arabinose, intestinal size and gene expression of several tight junction proteins (claudin-2, claudin-4, claudin-15 and ZO-1) at three time points: pre-exposure, and after 1 day and 2 weeks of cold exposure. Cold exposure increased food intake by 62% after 2 weeks but intake was not significantly increased after 1 day. Intestinal wet mass was elevated after 1 day and throughout the experiment. Absorption of arabinose rose by 20% after 1 day in the cold and was 33% higher after 2 weeks. Expression of claudin-2 increased after 1 day of cold exposure, but there were no changes in expression of any claudin genes when normalized to ZO-1 expression. Our results indicate that intestinal mass can respond rapidly to increased energy demand and that increased paracellular permeability is also part of that response. Increased paracellular permeability may be a consequence of enterocyte hyperplasia, resulting in more tight junctions across which molecules can absorb.

Correlation between levels of circulating adipokines and adiponectin/resistin index with carotid intima-media thickness in hypertensive type 2 diabetic patients.

BACKGROUND: Hypoadiponectinemia and hyperresistinemia are associated with cardiovascular disease. The increase in the carotid intima-media thickness (CIMT) assessed by B-mode ultrasound has been directly associated with increased risk of myocardial infarction and stroke. OBJECTIVE: To evaluate the correlation between adipokine levels with CIMT in hypertensive type 2 diabetic patients. METHODS: Serum levels of adiponectin and resistin levels were measured by ELISA in 30 type 2 diabetic patients with never-treated hypertension and in age-matched healthy controls. The CIMT (B-mode color imaging of extracranial carotid arteries using high-resolution ultrasound) was also obtained. The relationship between adipokine levels and the adiponectin/resistin index with the CIMT was assessed by the Pearson correlation coefficient test. RESULTS: Adiponectin was lower (p < 0.05), and resistin higher (p < 0.01) in patients than in controls, CIMT correlated positively with resistin (R = 0.45, p < 0.02) and the adiponectin/resistin index (R = 0.58, p < 0.001), but not with adiponectin levels (r = -0.11, p > 0.1) in patients. Whereas only adiponectin levels correlated - negatively - with CIMT (r = -0.39, p < 0.02) in controls. CONCLUSION: Our results shown that the adiponectin/resistin index seems to be more strongly associated with atherosclerosis than adipokine levels, and may be used as a reliable marker of cardiovascular risk in type 2 diabetic hypertensive patients.

Depression increases the risk for uncontrolled hypertension.

BACKGROUND: Because hypertension and depression share common pathways, it is possible that each disease has an impact on the natural history of the other. OBJECTIVE: To determinate whether depression influences blood pressure control in hypertensive patients. METHODS: Forty hypertensive patients undergoing antihypertensive treatment, excluding beta-blockers and central-acting agents, self-measured their blood pressure several times a day for three days using a validated, commercially available device. All patients also completed the Zung Self-rating Depression Scale survey for depression. Associations between the results of the blood pressure and depression tests were determined using the Spearman correlation coefficient; RR was also measured. RESULTS: Of the 40 patients, 23 were depressed, and 21 of these 23 had poor control of their blood pressure. The RR for uncontrolled hypertension in depressed patients was 15.5. A significant correlation between systolic (r=0.713) and diastolic (r=0.52) blood pressure values and depression was found. CONCLUSION: Depression is common in patients with uncontrolled hypertension and may interfere with blood pressure control. Screening for depression in hypertensive patients is a simple and cost-effective tool that may improve outcomes.

Beneficial effect of combination therapy using an angiotensin-converting enzyme inhibitor plus verapamil on circulating resistin levels in hypertensive patients with type 2 diabetes.

BACKGROUND: Resistin levels are strongly correlated with insulin resistance and vascular inflammation. Type 2 diabetic and hypertensive patients have higher circulating levels of resistin, which is associated with endothelial dysfunction. OBJECTIVE: To compare the effect of trandolapril (T) and its fixed-dose combination with verapamil (FDTV) on resistin levels in hypertensive, type-2 diabetic patients. METHODS: Forty type-2 diabetic patients with never-treated hypertension were randomly assigned to two groups. One group received FDTV 2 mg/180 mg once per day; the other group received T 2 mg once per day. Study drugs were administered for three months in both groups. Resistin levels were measured using ELISA at the beginning of the study and at study end. Patients were evaluated monthly for blood pressure, fasting serum glucose levels and adverse events. Statistical analysis was performed using ANOVA. RESULTS: All patients experienced a significant reduction in blood pressure. Both therapeutic regimens reduced resistin levels; however, FDTV treatment resulted in a greater decrease in resistin levels (mean [± SD] 25.5±13 ng/mL to 17.2±10 ng/mL) when compared with T treatment (22.4±12 ng/mL to 18.5±8 ng/mL) (P<0.05). None of the patients experienced an adverse event. CONCLUSION: Results showed that FDTV resulted in a greater reduction in resistin levels than T treatment alone.

[Validation of diagnosis scales for differencing hemorrhagic from ischemic cerebral vascular disease]. / Escalas clínicas para diferenciar enfermedad vascular cerebral hemorrágica de isquémica.

BACKGROUND: differentiating hemorrhagic from ischemic cerebral vascular disease (CVD) is the starting point for the treatment. The aim was to compare the diagnostic accuracy of the scales that differentiate hemorrhagic from ischemic stroke. METHODS: we applied the scale of Siriraj Stroke Score (SSS) and Greek Stroke Score (GSS) to patients with stroke. The results were described as means and frequencies. For significant variables odds ratio was calculated. We calculated the validity of both scales compared to the head computed tomography. RESULTS: ninety one patients had ischemic stroke and 28 were hemorrhagic. The mean systolic blood pressure in ischemic stroke was 138.94 mmHg (SD ± 26.90) and hemorrhagic was 165.55 mmHg (SD ± 36.40) p = 0.0007. The atherogenic index (AT) in ischemic stroke was 4.52 (SD ± 1.52) and in hemorrhagic was 4.84 (SD ± 2.01) p = 0.87. The specificity of the SSS for hemorrhagic stroke is 85.5 % and 96.7 % for the GSS. CONCLUSIONS: the GSS has a high specificity for hemorrhagic stroke.

2640 Meters Closer to the Stars: Does High Altitude Affect Fontan Results?

BACKGROUND: Risk factors for and postoperative results of the Fontan operation in patients living at high altitude (>2500 meters above sea level) in the Andean region remain unknown. This study was conducted to evaluate immediate postoperative outcomes and to assess short- and long-term functional class after the Fontan operation. METHODS: From June 2003 to February 2019, 104 patients receiving the Fontan procedure at 2640 meters (8661 feet) above sea level were retrospectively studied. Preoperative catheterization, intraoperative variables, and postoperative outcomes were described. Functional class was evaluated in patients living permanently below (group I) and at or higher than 2500 meters (8202 feet) above sea level (group II). Risk factors for mortality were analyzed. RESULTS: Median age at operation was 8.5 ± 4.4 years; pulmonary artery pressure, 16.2 ± 3.6 mm Hg; end-diastolic systemic ventricular pressure, 13.3 ± 3.8 mm Hg; and pulmonary vascular resistance index, 2.1 (interquartile range, 07-3.7) Wood units. Chest tube duration was 8.5 (6-12) days. Mortality was 4.8%, with 0 in the last 5 years. Higher preoperative pulmonary pressure (16.2 ± 3.6 mm Hg vs 21.2 ± 3.40 mm Hg; P = .01), aortic cross-clamp time (P < .001), and renal failure (P < .01) were associated with mortality. Functional class improved to class I in 86.4%. Overall survival was 90.7% at 10 years of follow-up. CONCLUSIONS: Increased pulmonary pressure and pulmonary vascular resistance index are directly related to high altitude. The Fontan-Kreutzer operation performed at high altitude in the Andean region is feasible with good results. We routinely fenestrate all cases to avoid dysfunction in the early postoperative period. Functional status is adequate after the operation.

A putative siderophore receptor of Gallibacterium anatis 12656-12 under Fur control also binds hemoglobin.

Pasteurellaceae family members obtain iron directly from host proteins or through siderophore-dependent mechanisms. Although Gallibacterum anatis expresses different virulence factors, its response to growth under iron restriction is unknown. G. anatis cultured in the presence of 2,2'-dipyridyl, up-expressed an approximately 65 kDa protein and repressed the expression of a 70 kDa protein. MALDI-TOF analysis of those proteins indicated homology with CirA (65 kDa), a protein involved in iron-siderophore acquisition in Mannheimia succinoproducens and a TonB-dependent receptor (70 kDa protein), a protein that binds chicken hemoglobin; however, G. anatis siderophore production was not detected by chromo azurol S (CAS)-BHI agar determination. This putative G. anatis siderophore receptor is under Fur control, but not the hemoglobin binding protein, as observed in G. anatis 12656-12 fur mutant (Ω fur 126.13) grown in the presence or not of 2,2'-dipyridyl. The addition of FeCl3 to the culture medium diminished the growth and biofilm production in approximately 30% and 35%, respectively, in the wild-type strain, but the growth of Ω fur 126.13 strain was not affected and biofilm production increased in 35%. G. anatis Ω fur 126.13 presented lower virulence when it was inoculated to 35-day-old chickens in comparison to the wild-type strain. The induction of more than one iron uptake mechanism could benefit pathogenic microorganisms such as Gallibacterium.

An outlook on future design of hybrid PET/MRI systems.

Early diagnosis and therapy increasingly operate at the cellular, molecular, or even at the genetic level. As diagnostic techniques transition from the systems to the molecular level, the role of multimodality molecular imaging becomes increasingly important. Positron emission tomography (PET) and magnetic resonance imaging (MRI) are powerful techniques for in vivo molecular imaging. The inability of PET to provide anatomical information is a major limitation of standalone PET systems. Combining PET and CT proved to be clinically relevant and successfully reduced this limitation by providing the anatomical information required for localization of metabolic abnormalities. However, this technology still lacks the excellent soft-tissue contrast provided by MRI. Standalone MRI systems reveal structure and function but cannot provide insight into the physiology and/or the pathology at the molecular level. The combination of PET and MRI, enabling truly simultaneous acquisition, bridges the gap between molecular and systems diagnosis. MRI and PET offer richly complementary functionality and sensitivity; fusion into a combined system offering simultaneous acquisition will capitalize the strengths of each, providing a hybrid technology that is greatly superior to the sum of its parts. A combined PET/MRI system provides both the anatomical and structural description of MRI simultaneously with the quantitative capabilities of PET. In addition, such a system would allow exploiting the power of MR spectroscopy (MRS) to measure the regional biochemical content and to assess the metabolic status or the presence of neoplasia and other diseases in specific tissue areas. This paper briefly summarizes state-of-the-art developments and latest advances in dedicated hybrid PET/MRI instrumentation. Future prospects and potential clinical applications of this technology will also be discussed.

[Insulin, renin-angiotensin system, aldosterone and endothelial dysfunction]. / Insulina, sistema renina-angiotensina-aldosterona y disfunción endotelial.

Beyond its metabolic effects, insulin has several actions on the vasculature. Under normal conditions, insulin maintains normal endothelial function, but in the presence of insulin resistance, insulin leads to endothelial dysfunction. Insulin releases nitric oxide, which promotes an antiatherosclerotic, antiinflamatory and vasodilated state. However, in presence of high levels of angiotensin II, insulin activates pathways that lead to atherosclerosis, vasoconstriction and inflammation. We will review the actions of insulin on the vascular system, and its interactions with other vasoactive mediators, such as angiotensin II and endothelin-1.

[Ankle-brachial index and albuminuria correlation in diabetic patients with normal blood pressure]. / Índice brazo-tobillo y albuminuria en pacientes diabéticos normotensos.

BACKGROUND: both, the ankle-brachial index < 0.9, and microalbuminuria are considered markers of endothelial dysfunction. Our objective was to evaluate if there is a correlation between the ankle-brachial index (ABI) and the degree of albuminuria in diabetic normotensive patients. METHODS: we included 32 diabetic normotensive patients and measured their ABI, and their 24-h urinary albumin excretion by nephelometry; the ABI and albuminuria were correlated with the Spearman correlation coefficient. RESULTS: we did not find overall correlation between the ABI and albuminuria (r = 0.21, 95 % CI = -0.14-0.52, p = 0.12); However, when we measured the correlation of an ABI < 0.9 with any degree of albuminuria, we found a significant correlation (r = -0.32 ± 0.11, 95 % CI = 0.027 to -0.6, p = 0.03); and when the correlation of ABI with albuminuria > 300 mg, we also found a significant correlation (r = -0.45 ± 0.11, 95 % CI = -0.015 to -0.76, p = 0.3). CONCLUSIONS: our results suggest that ABI < 0.9 is a useful marker to estimate microalbuminuria in diabetic normotensive patients.

[Ankle-brachial index assessed in a Mexican population with vascular risk. The INDAGA study]. / Estudio multicéntrico INDAGA. Índice tobillo-brazo anormal en población mexicana con riesgo vascular.

OBJECTIVE: to know the peripheral arterial disease (PAD) prevalence and its determinants in a nationwide survey in Mexican population. METHODS: baseline ankle brachial index (ABI) measured by Doppler was performed in patients at high vascular risk for PAD. ABI between 1 and 1.3 was regarded as normal. ABI ≤ 0.9 (a low ABI) was considered to be an indicator of PAD. ABI > 1.3 (a high ABI) was also considered abnormal, as an indirect index of artery calcification and stiffness. RESULTS: a total of 5 101 patients were evaluated: 1,212 patients (23.8 %) had ABI ≤ 0.9, and 431 (8.4 %) > 1.3 (including 1 % with incompressible vessels). ABI ≤ 0.9 was associated with age, arterial hypertension, diabetes, current smoking, dyslipidemia and previous vascular events. On the other hand, ABI > 1.3 was associated with male gender, diabetes, previous smoking habit and history of vascular events. A high proportion of patients (62.5 %) with established PAD, identified by a low ABI (≤ 0.9) were asymptomatic or with minimum symptoms at the time of their assessment. CONCLUSION: a significant prevalence of abnormal ABI was identified. ABI measurement by Doppler can help to identify patients who need intense secondary prevention and more aggressive treatment of vascular risk factors.

Epidemiology of thymic epithelial tumors: 22-years experience from a single-institution.

BACKGROUND: To assess the correlation of WHO histological classification and Masaoka-Koga staging system of thymic epithelial tumors (TETs) with prognosis. METHODS: We retrospectively analyzed 83 patients with TETs in the Instituto Nacional de Enfermedades Neoplasicas between 1996 to 2018. We analyzed the clinical stages, histological types and treatment modalities and attempted to determine the impact on overall survival. The data was retrieved from clinical files and reviewed by a pathologist who reclassificated according to the 2004 WHO classification system. The staging was performed with the Masaoka-Koga staging system. Survival curves were constructed with Kaplan-Meir method. RESULTS: There was a total of 83 patients with a median age of 55 years old included in the study. The histological type corresponded to thymoma (T) in 63.8% (n = 53) and to thymic carcinoma (TC) in 36.1%. T were type A, AB, B1, B2 and B3 in 14.4%, 18%, 12%, 3.6%, 7.4% of cases, respectively. The proportion of advanced disease (Masaoka stage III-IV) was high (65%). With a median follow-up of 88.4 months, median overall survival (OS) was 81.6 months for T and 12.3 months for TC (P = 0.01). Univariate analysis showed that sex, histological type, clinical stage and surgery (P = 0.01) were significant independent prognostic factors. On multivariate analysis, histology type and Masaoka-Koga staging had an effect on survival. CONCLUSIONS: The results indicates a clear association between the WHO histological classification and Masaoka-Koga staging system with survival. We found a higher proportion of TETs with advanced disease at diagnosis. Further research are required and collaboration is important to foster knowledge focused on classification and treatment. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: The WHO histological classification, the Masaoka-Koga system and surgery treatment were associated with overall survival. WHAT THIS STUDY ADDS: To determine prognosis factors in TETs.

Correlation between the levels of circulating adhesion molecules and atherosclerosis in hypertensive type-2 diabetic patients.

Endothelial dysfunction is a common feature in type-2 diabetic patients and in hypertension, and is associated with inflammation, increased levels of circulating soluble adhesion molecules, and atherosclerosis. The aim of this study was to evaluate the relationship between the levels of circulating soluble adhesion molecules and the degree of atherosclerosis in hypertensive type-2 diabetic patients. We studied 30 hypertensive type-2 diabetic patients in whom VCAM-1, ICAM-1, and E-selectin were measured by ELISA. Additionally, the intimal-medial thickness of both the common and internal carotid arteries was measured (B-mode ultrasound). The levels of circulating adhesion molecules and maximal carotid artery intimal-medial thicknesses were correlated using the Spearman correlation coefficient test. Statistical analysis was performed with ANOVA. We found significant correlations between ICAM-1 (r = 0.5) levels and maximal carotid artery intimal-medial thickness these patients. No correlation was observed with E-selectin and VCAM-1. Our results suggest that ICAM-1 is associated and correlated with the degree of atherosclerosis in type-2 diabetic hypertensive patients.