Incidence and Factors Associated With Second Primary Invasive Melanoma in Norway.

Importance: Patients diagnosed with a primary melanoma are at high risk of subsequent melanomas. Understanding the risk of second primary invasive melanoma and associated factors is crucial to optimize patient follow-up. Objective: To assess the incidence rate of second primary invasive melanoma and time between the first and second primary invasive melanoma in the Norwegian population. Design, Setting, and Participants: This population-based cohort study included data from deidentified records of all invasive melanomas diagnosed in Norway in 2008 to 2020, obtained from the Cancer Registry of Norway. Data were from adults aged 18 years or older diagnosed with a first primary melanoma. Data analysis was performed from March to August 2023. Main Outcomes and Measures: The main outcome was the incidence rate of second primary invasive melanoma at least 30 days after the first. Accelerated failure time models were fitted to examine potential associations with patient and tumor characteristics. Median time between first and second primary melanomas and 95% CIs were calculated. The likelihood of, and median interval for, second primary melanomas on the same or different site as the first primary were calculated. Results: A total of 19 196 individuals aged 18 years or older were diagnosed with a first primary melanoma. The mean (SD) age at diagnosis of the first primary melanoma was 62 (16) years (range, 18-104 years), and 9763 (51%) were female. The incidence rate in the year following diagnosis was 16.8 (95% CI, 14.9-18.7) per 1000 person-years, which decreased to 7.3 (95% CI, 6.0-8.6) during the second year and stabilized thereafter. Median time between first and second primaries decreased with advancing age and was 37 months (95% CI, 8-49) in patients younger than 40 years, 18 (95% CI, 13-24) in patients aged 50 to 59 years, and 11 (95% CI, 7-18) in patients aged 80 years or older. The second primary was on the same site as their first primary for 47% (359 patients), and on a different site for 53% (407 patients). The median interval until second melanoma on the same site as the initial melanoma was 12 (95% CI, 7-19) months in men and 22 (95% CI, 11-35) months in women. Conclusions and Relevance: Older age and male sex were associated with an increased risk, suggesting that increased surveillance intensity may be considered for men, especially those older than 50 years, for at least 3 years after their initial diagnosis, regardless of the characteristics of their first invasive melanoma.

Inulin-type fructans with different degrees of polymerization improve insulin resistance, metabolic parameters, and hormonal status in overweight and obese women with polycystic ovary syndrome: A randomized double-blind, placebo-controlled clinical trial.

Polycystic ovary syndrome (PCOS) is associated with reproductive disorders and adverse cardiometabolic risk factors that can negatively impact the general health of women. Inulin-type fructans (ITFs) are proposed to beneficially affect risk factors associated with metabolic disorders. Whether ITFs can help with the management of PCOS by modifying insulin resistance (IR) and androgen levels has not yet been explored. The aim of this study was to investigate the effects of ITFs with different degrees of polymerization on insulin resistance, blood lipids, anthropometric measures, and hormonal status in overweight and obese women with PCOS. In a randomized double-blind placebo-controlled trial, seventy-five women with PCOS aged 18-40 years old were randomly assigned to receive 10 g/day of high-performance inulin (HPI) or oligofructose-enriched inulin (OEI) or maltodextrin for 12 weeks. Biochemical and clinical outcomes were measured at baseline and after the intervention. Participants in the HPI and OEI groups experienced improvements in waist circumference, total testosterone, free androgen index, sex hormone-binding globulin, and triglycerides compared to the placebo group. Also, the number of women with irregular menses or oligomenorrhoea decreased significantly in both ITF groups. Participants in the HPI group reported lower body mass, fasting insulin, and HOMA-IR, as well as a higher quantitative insulin sensitivity check index. ITF supplementation, especially with long-chain ITFs, when given for 12 weeks may improve metabolic outcomes, androgen status and clinical manifestations in women with PCOS.

Potential mechanisms linking probiotics to diabetes: a narrative review of the literature / Mecanismos potenciais ligando probióticos a diabetes: uma revisão narrativa da literatura

ABSTRACT CONTEXT AND OBJECTIVE: Some studies have suggested a wide range of possible mechanisms through which probiotics may play a role in diabetes prevention and treatment. However, the underlying mechanisms are not fully understood. We conducted this study to review the potential mechanisms suggested for the effect of probiotics in diabetes. DESIGN AND SETTING: Narrative review conducted at the Food Security Research Center of Isfahan. METHODS: A search in the electronic databases MEDLINE (PubMed), Cochrane Library, Web of Science and Google scholar was performed up to October 2016. RESULTS: The initial search yielded 1214 reports. After removing duplicates, 704 titles and abstracts were screened. Finally, out of 83 full-text articles that were reviewed for eligibility, 30 articles were included in the final analysis. The anti-diabetic mechanisms for probiotics reported encompass intraluminal and direct effects on the intestinal mucosa and microbiota (n = 13), anti-inflammatory and immunomodulatory effects (n = 10), antioxidative effects (n = 5), effects on endoplasmic reticulum (ER) stress and expression of genes involved in glucose homeostasis and insulin resistance (n = 6), with some studies pointing to more than one mechanism. CONCLUSION: The results may throw some light on the capacity of probiotics as a novel approach towards controlling diabetes. However, further human studies are warranted to elucidate and confirm the potential role of probiotics in diabetes prevention and treatment. Also, it needs to be ascertained whether the effectiveness of probiotics in diabetes prevention and treatment is dependent on the strain of the microorganisms.

RESUMO CONTEXTO E OBJETIVO: Alguns estudos têm sugerido ampla gama de possíveis mecanismos, pelos quais os probióticos podem desempenhar um papel na prevenção e tratamento do diabetes. No entanto, os mecanismos subjacentes não são totalmente compreendidos. Realizamos este estudo para revisar os possíveis mecanismos sugeridos para o efeito dos probióticos na diabetes. TIPO DE ESTUDO E LOCAL: Revisão narrativa conduzida no Food Security Research Centro de Isfahan. MÉTODOS: Busca sistemática nas bases de dados eletrônicas MEDLINE (PubMed), Cochrane Library, Web of Science e Google scholar até outubro de 2016. RESULTADOS: A busca inicial resultou em 1.214 artigos. Após a remoção de duplicatas, foram pesquisados 704 títulos e resumos. Finalmente, de 83 artigos completos revisados para elegibilidade, 30 foram incluídos na análise final. Os mecanismos antidiabéticos relatados dos probióticos abrangem efeitos intraluminais e diretos na mucosa e microbiota intestinal (n = 13), efeitos anti-inflamatórios e imunomoduladores (n = 10), efeitos antioxidativos (n = 5), efeitos sobre o estresse de retículo endoplasmático (RE) e expressão de genes envolvidos na homeostase da glicose e resistência à insulina (n = 6), com alguns estudos apontando para mais de um mecanismo. CONCLUSÃO: Os resultados podem lançar alguma luz sobre os probióticos como uma nova abordagem no controle do diabetes, no entanto, mais estudos em humanos são justificados para elucidar e confirmar o papel potencial dos probióticos na prevenção e tratamento do diabetes. Além disso, deverá ser determinado se a eficácia dos probióticos na prevenção e tratamento do diabetes é dependente da cepa dos microrganismos.