Evaluation of laser therapy and alpha-lipoic acid for the treatment of burning mouth syndrome: a randomized clinical trial.

The aim of this study was to evaluate the efficacy of low-level laser therapy (LLLT) and alpha-lipoic acid (ALA) in the treatment of burning mouth syndrome (BMS) and secondary oral burning (SOB) by unstimulated sialometry, symptom assessment, and measurement of salivary TNF-α levels. Forty-four patients were randomized into four treatment groups: BMS/laser (n = 10), BMS/ALA (n = 5), SOB/laser (n = 15), and SOB/ALA (n = 14). The control group consisted of eight healthy female subjects. Unstimulated salivary flow was measured before and after treatment, and the collected saliva was stored at - 20 °C for the analysis of TNF-α. Symptoms were evaluated before and after treatment using a pain visual analog scale. Most patients were women (81.8%) during menopause (72.2%). LLLT and ALA were efficient in increasing salivary flow only in BMS but provided symptom relief in both conditions. TNF-α levels did not differ between patients with BMS and SOB or between those patients and the control group. No differences were observed in posttreatment TNF-α levels in either condition. The results of this study suggest that LLLT and ALA are efficient therapies in reducing burning mouth symptoms, with LLLT being more efficient than ALA.

Diet-Induced Weight Loss Reduces DNA Damage and Cardiometabolic Risk Factors in Overweight/Obese Women with Polycystic Ovary Syndrome.

AIMS: We aimed to investigate the impact of following a diet to induce weight loss (500 kcal deficit per day) over DNA damage and cardiometabolic risk factors in women with overweight/obesity diagnosed with polycystic ovary syndrome (PCOS). METHODS: A study was conducted in Natal, RN, Brazil selecting overweight/obese (body mass index ≥25 and <39 kg/m2) women (18-35 years). The levels of DNA damage were assessed by a single cell gel electrophoresis. Repeated 24 h dietary recall questionnaires, anthropometry, biochemical profile and sex hormones were collected at baseline and after 12 weeks of intervention. RESULTS: Women exhibiting a decrease in the markers of DNA damage: tail intensity (24.35 ± 5.86 - pre diet vs. 17.15 ± 5.04 - post-diet; p < 0.001) and tail moment (20.47 ± 7.85 - pre diet vs. 14.13 ± 6.29 - post-diet; p < 0.002). Reduction of calorie intake, weight loss, decreased sexual hormone and cardiometabolic markers such as insulin, homeostasis model assessment of insulin resistance and low-density lipoprotein cholesterol were verified In the multivariate regression analysis, quantitative insulin sensitivity check index and progesterone were responsible for the variation markers in DNA damage before the diet, losing its influence upon diet. CONCLUSION: DNA damage and the impact of cardiometabolic risk factors decreased after the intervention in women with PCOS, indicating the relevance of a nutritional approach in this group of patients.

Quality of Life and Hormonal, Biochemical, and Anthropometric Profile Between Olanzapine and Risperidone Users.

This cross-sectional study compared quality of life and side effects in 108 users of olanzapine or risperidone suffering schizophrenia and being attended at psychiatric ambulatory services in Rio Grande do Norte, Brazil. Economic, socio-demographic, anthropometric, biochemical, and hormonal variables were compared. The EuroQoL Five-Dimension Scale (EQ-5D) was used to evaluate quality of life, and side effects were assessed using the Udvalg for Kliniske Undersøgelser (UKU) Side Effect Rating Scale and the Simpson-Angus Scale. Data were analysed using the χ(2) test and Student's t test, with a significance level of 5 %.The household incomes of approximately 80 % of patients were <2.0 minimum wages ($678). Anthropometric variables (waist circumference, hip circumference, weight, waist-to-hip ratio) and systolic and diastolic blood pressure were noted among male olanzapine users (all p < 0.05). EQ-5D scores showed that olanzapine use significantly impacted self-help ability (p < 0.001). Risperidone users had a mean quality-adjusted life year value of 1. Mean total Simpson-Angus Scale scores was 0.38 for olanzapine users and 0.11 for risperidone users (p < 0.02). Significant differences in UKU were observed for the following items: asthenia/lassitude/fatigue (higher among olanzapine users, p = 0.02), dystonia (higher among olanzapine users, p = 0.01), tremors (higher among olanzapine users, p = 0.03), gynecomastia (higher among risperidone users, p < 0.02), and ejaculatory dysfunction (higher among risperidone users, p < 0.02). Olanzapine users had impaired quality of life, which can be explained in part by adverse motor, biochemical, and hormonal effects characteristic of metabolic syndrome.

The impact of body mass on inflammatory markers and insulin resistance in polycystic ovary syndrome.

OBJECTIVE: To evaluate inflammatory markers and insulin resistance (IR) in women with and without polycystic ovary syndrome (PCOS), with different body mass index (BMI). METHODS: Tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) were assessed in serum samples from 40 women in reproductive age. Patients were divided into four groups: I (non-eutrophic with PCOS, n = 12), II (non-eutrophic without PCOS, n = 10), III (eutrophic with PCOS, n = 8) and IV (eutrophic without PCOS, n = 10) being non-eutrophic, the overweight and obese women with BMI > 25 kg/m2 and eutrophic women with BMI < 24.9 kg/m2. Homeostatic model assessment (HOMA-IR) was calculated for evaluation of IR. RESULTS: PCOS patients showed increased levels of CRP (p < 0.01) and HOMA-IR (p < 0.01). When divided by BMI, both non-eutrophicad eutrophic PCOS showed increased CRP levels (p < 0.01) and HOMA-IR (p < 0.01). There were no differences in TNF-α and IL-6 levels between groups. CONCLUSION: In the PCOS group, the levels of CRP and IR were elevated, compared to their counterparts, regardless of body mass.

Affect-regulated exercise: an alternative approach for lifestyle modification in overweight/obese women with polycystic ovary syndrome.

OBJECTIVE: Affect-regulated exercise ("ARE") is an alternative approach to guide exercise intensity based on feeling of pleasure. The aim of this study was to analyze if overweight/obese women with polycystic ovary syndrome (PCOS) meet the American College of Sports Medicine (ACSM) recommendation regarding to exercise intensity to improve health status during a single bout of "ARE". METHODS: A sample of 14 overweight/obese women with PCOS (18-34 years) performed a single bout of "ARE" (40 min of aerobic exercise on outdoor track). The Feeling Scale (FS) was used to guide "ARE" intensity/pace maintaining an affective valence between "good" and "very good" during all time. Heart rate (HR), speed, % of HR at first and second ventilatory threshold (VT1 and VT2) and time spent at moderate (64-76% of HR(max)) and vigorous (77-95% of HR(max)) intensity during "ARE" were measured with a global positioning system (GPS) device. RESULTS: Volunteers exercised at 73% (68-78%) of HR(max), 5.8 (5.2-6.2) km/h, 93.4% of HR at VT1 (89.3-98.2) and 80.5% of HR at VT2 (75.3-84.6) and spent >80% of time at moderate intensity. CONCLUSIONS: Overweight/obese women with PCOS met the ACSM recommendation regarding exercise intensity to improve health status when exercised between "good" and "very good" of FS. Thus, "ARE" may be an interesting approach to be used in clinical practice regarding to exercise prescription and/or physical activity advice.

Effect of High-Intensity Interval, Moderate-Intensity Continuous, and Self-Selected Intensity Training on Health and Affective Responses.

Purpose: To compare the effects of 12-week high-intensity interval (HIIT), moderate-intensity continuous (MICT), and self-selected intensity training (SSIT) on health outcomes and affective responses. Methods: Seventy-three overweight/obese inactive adults (62% woman; age, 31.4 ± 7.2 years; height, 1.66 ± 0.09 cm; Body mass index, 28.9 ± 2.7 kg.m-2) who were randomized into HIIT (n = 23), MICT (n = 24) and SSIT (n = 26) groups. The training was conducted three times per week in an outdoor environment, with 4 weeks under direct supervision and 8 weeks with semi-supervision. Cardiorespiratory fitness, body composition, and metabolic profile were evaluated at baseline and at the end of the 4th and 12th weeks. Core affect was measured during all training sessions. Results: Peak oxygen uptake improved in all groups after 4 and 12 weeks compared with baseline. Only the SSIT had reductions in body fat throughout the intervention. No improvements were observed in the metabolic profile across all groups. SSIT was perceived as more pleasurable than HIIT; however, there were no differences in affective responses between SSIT and MICT. Affective responses in-task (e.g. negative and positive peak, rate of change and affect at the end of the exercise session) predicted the HIIT and SSIT exercises attendance rate. Conclusion: Regardless of the exercise training protocol, overweight/obese inactive adults improved health outcomes, which suggests the prescribing HIIT, MICT, and SSIT in outdoor environments. SSIT should be considered in order to optimize the pleasure during training sessions. Affective response more positive in-task of the HIIT and SSIT is associated with greater attendance rate in these exercise protocols.

Anthropometric indices of central obesity how discriminators of metabolic syndrome in Brazilian women with polycystic ovary syndrome.

BACKGROUND: Central obesity is highly prevalent in women with polycystic ovary syndrome (PCOS) and is strongly associated with metabolic syndrome (MetS). OBJECTIVES: To define cut-off points of waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and conicity index (C-Index) to discriminate metabolic syndrome (MetS) in Brazilian women with PCOS. METHODS: In a cross-sectional study, anthropometric, biochemical and clinical parameters were measured in 113 Brazilian PCOS women (27.2 ± 4.5 years). Receiver operating characteristic (ROC) analysis was used to find out the cut-off points of anthropometric indices to predict MetS according with National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III) criteria. RESULTS: Considering the ROC curve analysis the WC and WHtR had a similar performance in predicting MetS and these parameters were better than WHR and C-Index. The optimal cut-off values of the anthropometric indices for discriminate MetS were: WC = 95 cm; WHtR = 0.59; WHR = 0.88; and C-Index = 1.25. By using these cut-off points the sensitivity and specificity rates of WC and WHtR were higher than those observed for WHR and C-Index. CONCLUSION: Our results indicated that WC and WHtR are more accurate than WHR and C-Index to predict MetS in Brazilian PCOS women.

Joint associations of accelerometer-measured physical activity and sedentary time with cardiometabolic risk in older adults: A cross-sectional study.

To investigate the joint associations of accelerometer-measured moderate-vigorous physical activity (MVPA) and sedentary time (ST) with cardiometabolic risk in older adults. This cross-sectional study included 248 participants (aged 65.8 ± 5.1 years; 73.7% females). Cardiometabolic risk was defined using continuous metabolic syndrome score (cMetS). MVPA and ST were assessed by accelerometry. Participants were categorized according to their MVPA and ST levels: i) 'Inactive + High ST' (<150 min/week and > 10.6 h/day); ii) 'Inactive + Low ST' (< 150 min/week and ≤ 10.6 h/day); iii) 'Active + High ST' (≥ 150 min/week and > 10.6 h/day) and iv) 'Active + Low ST' (≥ 150 min/week and ≤ 10.6 h/day). The cut-offs for active and inactive were based on current PA guidelines. The cut-offs for low and high ST were based on the median value from this cohort. Generalized linear models were used for data analyses ('Inactive + High ST' as group reference) controlling for known cardiometabolic risk factors. The 'Active + Low ST' (ß = -0.34, 95% CI -0.57, -0.11) and 'Active + High ST' (ß = -0.28, 95% CI -0.55, -0.02) groups had lower cMetS compared to the 'Inactive + High ST' group (p < 0.05). No difference was found between the 'Inactive + Low ST' and 'Inactive + High ST' groups (ß = -0.19, 95% CI -0.41, 0.03). Meeting MVPA recommendations (≥ 150 min/week) is associated with a lower cardiometabolic risk in older adults, even in those with high ST.

Analysis of heart rate variability in polycystic ovary syndrome.

OBJECTIVE: To compare the modulation of heart rate in a group of volunteers with polycystic ovary syndrome (PCOS) to that of a group of healthy ovulatory women on the basis of R-R interval variability and analyze the relationships between heart rate variability (HRV) and other cardiovascular risk factors. METHODS: In a cross-sectional study, HRV and anthropometric, biochemical and hormonal parameters were measured in 23 women with PCOS and 23 age-matched controls. Mean outcomes measures: HRV indexes in the time (SDNN and rMSSD) and frequency domain (low frequency-LF and high frequency-HF). Differences between groups and correlation analysis were performed. RESULTS: Intergroup analysis showed significant differences (p < 0.05) between groups, with lower SDNN, rMSSD, LF and HF indexes in PCOS women when compared to the control group. There was significant negative correlation between BMI and SDNN, LF and HF, indicating a decrease in the autonomic modulation of heart rate with increasing weight. A negative correlation was also found between the high-sensitivity C-reactive protein level and the rMSSD index. CONCLUSION: Our results show that PCOS is associated with alterations in the autonomic modulation of heart rate, possibly due to the influence of weight gain.

Spectrochemical analysis in blood plasma combined with subsequent chemometrics for fibromyalgia detection.

Fibromyalgia is a rheumatologic condition characterized by multiple and chronic body pain, and other typical symptoms such as intense fatigue, anxiety and depression. It is a very complex disease where treatment is often made by non-medicated alternatives in order to alleviate symptoms and improve the patient's quality of life. Herein, we propose a method to detect patients with fibromyalgia (n = 252, 126 controls and 126 patients with fibromyalgia) through the analysis of their blood plasma using attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy in conjunction with chemometric techniques, hence, providing a low-cost, fast and accurate diagnostic approach. Different chemometric algorithms were tested to classify the spectral data; genetic algorithm with linear discriminant analysis (GA-LDA) achieved the best diagnostic results with a sensitivity of 89.5% in an external test set. The GA-LDA model identified 24 spectral wavenumbers responsible for class separation; amongst these, the Amide II (1,545 cm-1) and proteins (1,425 cm-1) were identified to be discriminant features. These results reinforce the potential of ATR-FTIR spectroscopy with multivariate analysis as a new tool to screen and detect patients with fibromyalgia in a fast, low-cost, non-destructive and minimally invasive fashion.

Independent and combined associations of cardiorespiratory fitness and muscle strength with metabolic syndrome in older adults: A cross-sectional study.

BACKGROUND: Studies have shown that low cardiorespiratory fitness (CRF) and low muscle strength are independently associated with metabolic syndrome (MetS) in older adults. This study investigated the isolated and combined associations of low CRF and muscle strength with MetS in older adults. METHODS: This cross-sectional study included 184 older adults (71% women; aged 65.6 ±â€¯4.3 years) without a prior history of cardiovascular disease. CRF and muscle strength were assessed by the six-minute walking test and 30-s chair stand test, respectively. Results below the 25th percentile of the cohort were used to define low CRF and low muscle strength. MetS was defined according to NCEP-ATP III criteria. Poisson's regression with robust variance was used to determine the prevalence ratio (PR) for MetS. Reference group was composed by older adults with both CRF and muscle strength above 25th percentile. RESULTS: Prevalence of low CRF, low muscle strength, and combined low CRF and muscle strength was 22.8%, 17.9%, and 10.9%, respectively. The prevalence of MetS was 56.5% in the full cohort. Isolated low CRF (PR 1.05, 95% CI 0.73 to 1.52; p = 0.793) and muscle strength (PR 1.09, 95% CI 0.74 to 1.61; p = 0.651) were not associated with MetS in the adjusted analysis. Combined low CRF and muscle strength was associated with MetS (PR 1.45, 95% CI 1.09 to 1.93; p = 0.011). CONCLUSIONS: Older adults with combined, but not isolated, low CRF and muscle strength showed an increased risk for MetS.

Association of polymorphisms in IL-8, MMP-1 and MMP-13 with the risk and prognosis of oral and oropharyngeal squamous cell carcinoma.

OBJECTIVE: This study investigated the risk and prognostic value of single nucleotide polymorphisms (SNP) inIL-8, MMP-1 and MMP-13 in oral and oropharyngeal squamous cell carcinomas (SCCs). DESIGN: SNPs rs2227532 and rs4073 inIL-8, rs2071230 and rs470558 in MMP-1, and rs2252070 in MMP-13 were genotyped in 125 oral and oropharyngeal SCC patients and 130 healthy controls, using TaqMan allelic discrimination assays. Multiple logistic regression models were used to explore the association between SNPs and cancer development, as well as SNP-SNP interaction and gene-environmental factor (GxE) interaction. Univariate and multivariate methods were applied for survival analyses. RESULTS: With exception of rs2227532, all the SNPs were in Hardy-Weinberg equilibrium in the control. No associations between rs4073 in IL-8 and rs2071230 and rs470558 in MMP-1 were observed, but rs2252070 in MMP-13, in the dominant model, was associated in a protective manner to oral and oropharyngeal SCC (OR: 0.20, 95% CI: 0.06-0.71, p = 0.007). All SNPs interact significantly with cigarette smoking and alcohol consumption on susceptibility to oral and oropharyngeal SCC, but they showed no influence on survival of the patients. CONCLUSIONS: Our results show that rs2252070 inMMP-13 may confer protection effect against oral and oropharyngeal SCC. In addition, the combined effects of IL-8 (rs4073), MMP-1 (rs2071230 and rs470558) and MMP-13 (rs2252070) with environmental carcinogens, such as tobacco and alcohol, are related to increased risk for oral and oropharyngeal SCC development.

Psychological responses, muscle damage, inflammation, and delayed onset muscle soreness to high-intensity interval and moderate-intensity continuous exercise in overweight men.

We compared in-task affect to HIIE and MICE, and its relationship with time spent at different metabolic domains, perceived exertion (RPE), self-efficacy, enjoyment, and future intention of exercise in overweight inactive men. Muscle damage and soreness, and inflammation were assessed post-exercise. Fifteen participants (28.9 ±â€¯5.0 yr; 29.2 ±â€¯3.8 kg/m2) completed a HIIE (10 × 1 min at 100% Vmax, 1 min recovery) and MICE (20 min at 55-59% VO2reserve) session. Affect, alertness, RPE, and self-efficacy were assessed in-task, and enjoyment and future intention post-task. At baseline, 24 and 48 h, creatine kinase, lactate dehydrogenase, interleukin-6 and -10, tumor necrosis factor alpha, and muscle soreness were assessed. Affect (-3.1 ±â€¯1.8 vs. 0.8 ±â€¯1.8, P < .001) and self-efficacy (70 ±â€¯15 vs. 90 ±â€¯15%, P < .001) were lower, while RPE and alertness were higher in HIIE compared to MICE (Ps ≤ .02). Affect was negatively correlated with RPE in HIIE (r = -0.90) and MICE (r = -0.72), and time spent above respiratory compensation point in HIIE (r = -0.59). Affect was positively correlated with self-efficacy in MICE (r = 0.74). Enjoyment, future intention, muscle damage and soreness, and inflammation were similar between HIIE and MICE post-exercise. Therefore, in-task HIIE was experienced as unpleasant compared to MICE, but the psychological and physiological responses post-task were similar in overweight inactive men.

In Vivo and In Vitro Toxicity Evaluation of Hydroethanolic Extract of Kalanchoe brasiliensis (Crassulaceae) Leaves.

The species Kalanchoe brasiliensis, known as "Saião," has anti-inflammatory, antimicrobial, and antihistamine activities. It also has the quercetin and kaempferol flavonoids, which exert their therapeutic activities. With extensive popular use besides the defined therapeutical properties, the study of possible side effects is indispensable. The objective of this study is to evaluate the toxicity in vitro and in vivo from the hydroethanolic extract of the leaves of K. brasiliensis. The action of the extract (concentrations from 0.1 to 1000 uL/100 uL) in normal and tumor cells was evaluated using the MTT method. Acute toxicity and subchronic toxicity were evaluated in mice with doses of 250 to 1000 mg/kg orally, following recognized protocols. The in vitro results indicated cytotoxic activity for 3T3 cell line (normal) and 786-0 (kidney carcinoma), showing the activity to be concentration-dependent, reaching 92.23% cell inhibition. In vivo, the extract showed no significant toxicity; only liver changes related to acute toxicity and some signs of liver damage, combining biochemical and histological data. In general, the extract showed low or no toxicity, introducing itself as safe for use with promising therapeutic potential.

Comparação das respostas neuromusculares e bioquímicas entre pacientes com DPOC e indivíduos saudáveis / Comparison of neuromuscular and biochemical responses between patients with COPD and healthy subjects

Objetivo: Comparar as respostas neuromusculares e bioquímicas do dano e fadiga muscular do quadríceps femoral entre indivíduos com doença pulmonar obstrutiva crônica (DPOC) e saudáveis. Métodos: Estudo observacional, transversal e comparativo. A amostra foi composta por 18 indivíduos alocados em dois grupos distintos: Grupo DPOC (GD) e grupo saudáveis (GS), os quais foram avaliados por meio da espirometria, do desempenho neuromuscular do quadríceps, dos marcadores bioquímicos do dano e fadiga muscular, da fatigabilidade e da dor muscular. Resultados: Observou-se diferença estatisticamente significante na potência média entre o GD e GS (99,9 ± 21,0 vs 145,1 ± 51,5, respectivamente; p= 0,02) e uma tendência das médias de pico de torque (85,7 ± 24,4 vs 104,4 ± 31,0; p= 0,45) e trabalho total (1.305,5 ± 329,9 vs 1.671,5 ± 444,5; p= 0,06) serem menores no GD que no GS, respectivamente. A concentração da LDH imediatamente após o teste isocinético foi significantemente maior no GD que no GS (402,3 ± 33,6 vs 289,4 ± 33,6, respectivamente; p= 0,03). Conclusões: O presente estudo mostrou que pacientes com DPOC tem redução da capacidade de gerar força em um determinado período de tempo quando comparado a indivíduos saudáveis. A dosagem plasmática dos marcadores bioquímicos não permitiu confirmar que os pacientes com DPOC tem maior nível de dano muscular quando realizam exercício que os controles saudáveis.

Objective: To compare neuromuscular and biochemical responses of femoral quadriceps muscle damage and fatigue between chronic obstructive pulmonary disease (COPD) and healthy subjects. Methods: Observational, transversal and comparative study. The sample consisted of 18 subjects assigned to two distinct groups: COPD group (CG) and healthy group (HG), who were assessed by spirometry, quadriceps neuromuscular performance, biochemical markers of muscle damage and fatigue, fatigability and muscle pain. Results: Statistically significant difference was observed in mean power between CG and HG (99.9 ± 21.0 vs. 145.1 ± 51.5, respectively; p= 0.02) and a tendency of mean peak torque (85.7 ± 24.4 vs 104.4 ± 31.0, p= 0.45) and total work (1,305.5 ± 329.9 vs 1.671.5 ± 444.5; p= 0.06) were smaller in the CG than HG, respectively. The LDH concentration immediately after the isokinetic test was significantly higher in the CG than HG (402.3 ± 33.6 vs 289.4 ± 33.6, respectively; p= 0.03). Conclusions: The present study showed that patients with COPD have a reduced ability to generate force over a given period of time when compared to healthy subjects. The plasma levels of biochemical markers did not confirm that patients with COPD have a higher level of muscle damage when exercising than healthy controls.

Aerobic Training Improves Quality of Life in Women with Polycystic Ovary Syndrome.

PURPOSE: To investigate the effects of a supervised aerobic exercise training intervention on health-related quality of life (HRQL), cardiorespiratory fitness, cardiometabolic profile, and affective response in overweight/obese women with polycystic ovary syndrome (PCOS). METHODS: Twenty-seven overweight/obese inactive women with PCOS (body mass index, ≥ 25 kg·m; age 18 to 34 yr) were allocated into an exercise group (n = 14) and a control group (n = 13). Progressive aerobic exercise training was performed three times per week (~150 min·wk) over 16 wk. Cardiorespiratory fitness, HRQL, and cardiometabolic profile were evaluated before and after the intervention. Affective response (i.e., feeling of pleasure/displeasure) was evaluated during the exercise sessions. RESULTS: The exercise group improved 21% ± 12% of cardiorespiratory fitness (P < 0.001) and HRQL in the following domains: physical functioning, general health, and mental health (P < 0.05). Moreover, the exercise group decreased body mass index, waist circumference, systolic and diastolic blood pressure, and total cholesterol level (P < 0.05). The affective response varied from "good" to "fairly good" (i.e., positive affective response) in an exercise intensity-dependent manner during the exercise training sessions. CONCLUSIONS: Progressive aerobic exercise training improved HRQL, cardiorespiratory fitness, and cardiometabolic profile of overweight/obese women with PCOS. Moreover, the participants reported the exercise training sessions as pleasant over the intervention. These results reinforce the importance of supervised exercise training as a therapeutic approach for overweight/obese women with PCOS.

Plasma zinc in institutionalized elderly individuals: Relation with immune and cardiometabolic biomarkers.

Changes in zinc metabolism caused by aging and the institutionalization process may contribute to zinc deficiency in elderly individuals. Hypozincemia results in changes in glycemic, lipid, and inflammatory profiles. The aim of this study was to evaluate plasma zinc concentrations and their relationships with sociodemographic, dietary, inflammatory, and cardiometabolic biomarkers in institutionalized elderly individuals. A cross-sectional study was carried out including 255 elderly adults living in nursing homes. The associations between plasma zinc and dietary zinc intake, sociodemographic indicators, and glycemic, lipid, and inflammatory biomarkers were evaluated. Independent variables were analyzed according to quartiles of plasma zinc concentrations (Q1: <71.1 µg/dL; Q2: 71.1-83.3 µg/dL; Q3: <83.3-93.7 µg/dL; Q4: >93.7 µg/dL). The relationship between plasma zinc concentrations and predictor variables was also tested. In Q1, higher concentrations of the following variables were observed, compared with those in other quartiles: total cholesterol and low-density lipoprotein cholesterol (LDL-c; Q1 > Q2, Q3, Q4; all p <0.001); triglycerides (Q1 > Q3, Q4; all p < 0.001); interleukin (IL)-6 (Q1 > Q3, Q4; p = 0.024 and p = 0.010, respectively); tumor necrosis factor (TNF)-α (Q1 > Q3, p = 0.003). A significant reduction in plasma zinc concentrations was observed with increasing age-adjusted institutionalization time (Δ = - 0.10; 95% confidence interval [CI]: -0.18 to -0.01). The concentrations of total cholesterol (Δ = - 0.19; 95% CI: -0.23 to -0.15), LDL-c (Δ = - 0.19; 95% CI: -0.23 to -0.15), triglycerides (Δ = - 0.11; 95% CI: -0.16 to -0.06), IL-6 (Δ = - 1.41; 95% CI: -2.64 to -0.18), and TNF-α (Δ = - 1.04; 95% CI: -1.71 to -0.36) were also significantly increased. In conclusion, decreased plasma zinc concentrations were associated with longer institutionalization time and worse lipid and inflammatory profiles in elderly institutionalized individuals.

Frequency of metabolic syndrome and associated factors in institutionalized elderly individuals.

INTRODUCTION: Population aging generally accompanies an increase in chronic noncommunicable diseases, such as metabolic syndrome (MS). Nursing homes have provided a solution for the decreased ability of elderly individuals for self-care and familial difficulties in meeting the health care needs of elderly individuals. PURPOSE: The aim of the present study was to determine the frequency of MS and its associated factors in elderly individuals living in nursing homes. PATIENTS AND METHODS: This cross-sectional study was conducted with 202 institutionalized elderly individuals. MS was diagnosed according to the National Cholesterol Education Program - Adult Treatment Panel III criteria. Sociodemographic, clinical, and lifestyle factors were assessed to verify their association with MS by logistic regression. RESULTS: The MS frequency was 29.2%. The most frequent MS components were low high-density lipoprotein cholesterol level (63.9%) and abdominal obesity (42.7%). Factors associated with MS were female sex (prevalence ratio [PR]=2.16; 95% CI, 1.04-4.49), age-adjusted institutionalization time >50% (PR=2.38, 95% CI, 1.46-3.88), and high concentrations of interleukin-6 (PR=2.01; 95% CI, 1.21-3.32) and tumor necrosis factor-α (PR=1.70; 95% CI, 1.05-2.77). Moreover, it was verified that the likelihood of having MS was 1.85-fold higher (95% CI, 1.11-3.10) in the group with a diet characterized by very high energy, very low fat, and high dietary fiber. CONCLUSION: The occurrence of MS in institutionalized elderly individuals was higher in females, and individuals with longer age-adjusted institutionalization time, higher concentrations of immunologic biomarkers, and a dietary intake consisting of higher energy and fiber and lower total fat. The results of the study are useful for guiding health care programs aimed at institutionalized elderly individuals.

Manejo e Prevenção de Reações Adversas da Quimioterapia Antineoplásica com Platinas em Pacientes com Cânceres Esofágico e Gástrico: Revisão Sistemática da Literatura / Management and Prevention of Adverse Reactions to Platinum Antineoplastic Chemotherapy in Patients with Esophageal and Gastric Cancer: Systematic Literature Review / Manejo y Prevención de Reacciones Adversas a la Quimioterapia Antineoplásica con Platino en Pacientes con Cánceres de Esófago y Gástrico: Revisión Sistemática de la Literatura

Introdução: O câncer gástrico é a quinta doença maligna mais comum em todo o mundo. Trata-se do tumor maligno mais incidente na Ásia, especialmente na China. O carcinoma esofágico é um dos tipos mais agressivos de tumor maligno. Os tratamentos multimodais, incluindo quimioterapia neoadjuvante e quimiorradioterapia, são utilizados e podem causar fadiga, vômito, diarreia, alterações cutâneas, caquexia e neuropatia periférica, que podem ser efeitos colaterais importantes para muitos pacientes que realizam seus tratamentos. Objetivo: Realizar uma revisão sistemática sobre o manejo e a prevenção de reações adversas da quimioterapia antineoplásica com platinas em pacientes com câncer esofágico e tumor gástrico. Método: Para seleção dos artigos, foi realizada a busca em três bases de dados: MEDLINE/PubMed, Cochrane e Embase, com a estratégia PICO, variando os descritores MeSH/DeCs e operadores booleanos. Resultados: Foram encontrados 455 títulos, dos quais, após utilizar a diretriz PRISMA, restaram 15 artigos para a revisão sistemática, que abordavam o manejo e a prevenção de náusea e vômitos, neuropatia periférica, caquexia, suplementação de magnésio, tratamento de depressão e toxicidade geral. Conclusão: Verificou-se que náuseas, vômitos, neuropatia e hipomagnesemia tiveram maior número de estudos relacionados ao manejo e à prevenção desses sintomas, nos quais identificaram-se algumas sugestões de condutas com maior evidência para essas reações. As demais reações encontradas ainda carecem de mais estudos, principalmente nos casos de cânceres gástrico e esofágico

Introduction: Gastric cancer is the fifth most common malignancy worldwide. It is the most frequent malignant tumor in Asia, especially in China. Esophageal carcinoma is one of the more aggressive types of malignant tumor. Multimodal treatments, including neoadjuvant chemotherapy and chemoradiotherapy are utilized and can cause fatigue, vomiting, diarrhea, skin changes, cachexia, and peripheral neuropathy, which can be important side effects for many patients undergoing their treatments. Objective: Carry out a systematic review on the management and prevention of adverse reactions of antineoplastic chemotherapy with platinum in patients with esophageal cancer and gastric tumor. Method: To select the articles, a search was conducted in three databases: MEDLINE/PubMed, Cochrane and Embase, with the PICO strategy, alternating between MeSH/DeCs descriptors and Boolean operators. Results: 455 titles were found, of which, after using the PRISMA guideline, 15 articles remained for systematic review, addressing the management and prevention of nausea and vomiting, peripheral neuropathy, cachexia, magnesium supplementation, treatment of depression and general toxicity. Conclusion: The greatest number of studies addressing the management and prevention of the symptoms of nausea, vomits, neuropathy and hypomagnesemia were found, and it was possible to identify some suggestions of conducts to treat these reactions. More studies are necessary for the other reactions encountered, mainly in the cases of gastric and esophageal cancer

Introducción: El cáncer gástrico es la quinta neoplasia maligna más común en todo el mundo. Es el tumor maligno más común en Asia, especialmente en China. El carcinoma de esófago es uno de los tipos de tumores malignos más agresivos. Se utilizan tratamientos multimodales, que incluyen quimioterapia neoadyuvante y quimiorradioterapia que pueden provocar: fatiga, vómitos, diarrea, alteraciones cutáneas, caquexia y neuropatía periférica, que pueden ser efectos secundarios importantes para muchos pacientes sometidos a sus tratamientos. Objetivo: Realizar una revisión sistemática sobre el manejo y prevención de reacciones adversas de la quimioterapia antineoplásica con platino en pacientes con cáncer de esófago y tumor gástrico. Método: Para la selección de los artículos se realizó una búsqueda en tres bases de datos: MEDLINE/PubMed, Cochrane y Embase, con la estrategia PICO, variando los descriptores MeSH/DeCs y operadores booleanos. Resultados: Se encontraron 455 títulos, de los cuales, luego de utilizar la guía PRISMA, quedaron 15 artículos para revisión sistemática, que abordaron el manejo y prevención de náuseas y vómitos, neuropatía periférica, caquexia, suplementación con magnesio, tratamiento de la depresión y toxicidad general. Conclusión: Se verifico que náuseas, vómitos, neuropatía e hipomagnesemia tuvieron un mayor número de estudios relacionados con el manejo y prevención de los síntomas, en los cuales fue posible identificar algunas sugerencias de conducta con mayor evidencia de estas reacciones. Las otras reacciones encontradas aún necesitan más estudios, especialmente en casos de cánceres gástrico y de esófago

Polycystic ovary syndrome: aggressive or protective factor for the retina? Evaluation of macular thickness and retinal nerve fiber layers using high-definition optical coherence tomography.

Objective. To compare macular thickness (MT) and retinal nerve fiber layers (RNFL) between women with polycystic ovary syndrome (PCOS) and healthy women. Materials and Methods. The study included 45 women with PCOS and 47 ovulatory women undergoing clinical-gynecological and ophthalmic evaluations, including measurement of MT, RNFL, and optic disc parameters using optical coherence tomography. Results. The superior RNFL around the optic nerve was significantly thicker in PCOS than in healthy volunteers (P = 0.036). After stratification according to insulin resistance, the temporal inner macula (TIM), the inferior inner macula (IIM), the nasal inner macula (NIM), and the nasal outer macula (NOM) were significantly thicker in PCOS group than in control group (P < 0.05). Both the presence of obesity associated with insulin resistance (P = 0.037) and glucose intolerance (P = 0.001) were associated with significant increase in the PC1 mean score, relative to MT. A significant increase in the PC2 mean score occurred when considering the presence of metabolic syndrome (P < 0.0001). There was a significant interaction between obesity and inflammation in a decreasing mean PC2 score relative to macular RNFL thickness (P = 0.034). Conclusion. Decreased macular RNFL thickness and increased total MT are associated with metabolic abnormalities, while increased RNFL thickness around the optic nerve is associated with hormonal changes inherent in PCOS.