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Metabolic syndrome (MetS) is associated with higher cardiovascular and metabolic risks, as well as with psychosocial disorders. Data regarding quality of life (QoL) in patients with MetS, point towards a significative association between MetS and a worse QoL. It remains unclear whether MetS components and non-alcoholic fatty liver disease (NAFLD) are associated with QoL in these individuals. We aimed to evaluate the association between QoL of patients with MetS and prespecified metabolic parameters (anthropometric, lipidic and glucose profiles), the risk of hepatic steatosis and fibrosis, and hepatic elastography parameters. Cross-sectional study including patients from microDHNA cohort. This cohort includes patients diagnosed with MetS, 18 to 75 years old, followed in our tertiary center. The evaluation included anamnesis, physical examination, a QoL questionnaire (Short-Form Health Survey, SF-36), blood sampling and hepatic elastography. We used ordered logistic regression models adjusted to sex, age and body mass index to evaluate the associations between the QoL domains evaluated by SF-36 and the prespecified parameters. We included a total of 65 participants with MetS, with 54% being female and the mean age 61.9 ± 9.6 years old. A worse metabolic profile, specifically higher waist circumference, lower HDL, higher triglycerides, and more severe hepatic steatosis, were associated with worse QoL scores in several domains. We found no significant association of hepatic fibrosis with QoL. Our data suggests that there is a link between a worse metabolic profile (specifically poorer lipidic profile and presence of hepatic steatosis) and a worse QoL in patients with MetS. • There is scarce data on quality of life in MetS, regarding metabolic parameters. • We showed that higher waist circumference associated with worse QoL. • Lower HDL and higher triglycerides associated with worse QoL. • More severe hepatic steatosis but not fibrosis associated with worse QoL. [ABSTRACT FROM AUTHOR]

The medicinal uses of Calotropis procera are diverse, yet some of them are based on effects that still lack scientific support. Control of diabetes is one of them. Recently, latex proteins from C. procera latex (LP) have been shown to promote in vivo glycemic control by the inhibition of hepatic glucose production via AMP-activated protein kinase (AMPK). Glycemic control has been attributed to an isolated fraction of LP (CpPII), which is composed of cysteine peptidases (95%) and osmotin (5%) isoforms. Those proteins are extensively characterized in terms of chemistry, biochemistry and structural aspects. Furthermore, we evaluated some aspects of the mitochondrial function and cellular mechanisms involved in CpPII activity. The effect of CpPII on glycemic control was evaluated in fasting mice by glycemic curve and glucose and pyruvate tolerance tests. HepG2 cells was treated with CpPII, and cell viability, oxygen consumption, PPAR activity, production of lactate and reactive oxygen species, mitochondrial density and protein and gene expression were analyzed. CpPII reduced fasting glycemia, improved glucose tolerance and inhibited hepatic glucose production in control animals. Additionally, CpPII increased the consumption of ATP-linked oxygen and mitochondrial uncoupling, reduced lactate concentration, increased protein expression of mitochondrial complexes I, III and V, and activity of peroxisome-proliferator-responsive elements (PPRE), reduced the presence of reactive oxygen species (ROS) and increased mitochondrial density in HepG2 cells by activation of AMPK/PPAR. Our findings strongly support the medicinal use of the plant and suggest that CpPII is a potential therapy for prevention and/or treatment of type-2 diabetes. A common epitope sequence shared among the proteases and osmotin is possibly the responsible for the beneficial effects of CpPII. [ABSTRACT FROM AUTHOR]

In HIV-infected patients, combined antiretroviral therapy (cART) is associated to adipose tissue redistribution known as lipodystrophy and associated cardiometabolic risk. This study aimed to evaluate the evolution of body composition in HIV-infected patients, with and without lipodystrophy, over 2 yr. We evaluated anthropometric parameters and body composition by whole-body dual-energy X-ray absorptiometry in 144 HIV-infected patients on cART. We defined lipodystrophy by fat mass ratio. Lipodystrophy was present in 45.77% of the patients. These patients presented higher HIV infection duration, cART duration, and CD4+ cell count, with no differences regarding gender, age, body mass index, and viral load. Patients with lipodystrophy showed an increase in total fat mass (9.9%) and upper-limbs fat mass (17.6%), with a decrease in total, trunk, and lower-limbs fat-free mass (2.2%; 2.2%, and 3.9%, respectively), over 2 yr. In patients without lipodystrophy, the trunk fat-free mass decreased 1.9% over time, and no changes were observed in the other studied parameters. In patients with lipodystrophy, there was predominantly a central fat mass gain, with no changes in lower limbs, suggesting that peripheral adipocytes lose their regenerative capacity. [ABSTRACT FROM AUTHOR]

Study Design Cross-sectional and observational study. Purpose of the Study Assess upper limb (UL) activity limitations using the “Test d'Evaluation des Membres Supérieurs Des Personnes Agées” (TEMPA) in individuals with Parkinson's disease (PD) and verify its clinimetrics properties. Methods The following were evaluated: internal consistency, interrater and test-retest reliability; concurrent validity; convergent validity; know group's validity; minimal detectable change, floor and ceiling effects, and the relationship between UL activity limitations and the presence of freezing of gait. Results Excellent reliability and interrater agreement (intraclass correlation coefficient = 0.99 and κ = 0.92) and test-retest reliability (intraclass correlation coefficient = 0.97) were found, as well internal consistency (α = 0.99). A moderate negative correlation was found between TEMPA and section II of the Unified Parkinson's Disease Rating Scale (ρ = −0.58; P = .001), and moderate/low between the test and the Nine Hole Peg Test values of the right UL and moderate for left UL (ρ = 0.56 and ρ = 0.41; P = .001) (ρ = 0.52 and ρ = 0.51; P = .001 and P = .002), respectively. No significant relationship was found with freezing episodes ( P = .057). Discussion TEMPA is useful for assessing UL activity limitations in PD, have adequate clinimetrics properties and is capable of detecting the influence of motor symptoms during the carrying out of daily living tasks. No differences were found between freezers and no freezers. Level of Evidence N/A. [ABSTRACT FROM AUTHOR]

Background Obesity is associated with higher leukocyte counts, whereas weight loss decreases these counts. It is unknown if different bariatric surgery (BS) types have different effects on leukocytes. Objectives The aim of the study was to determine predictors of leukocyte and their subset count variation in patients submitted to BS. Setting Tertiary care university hospital, Porto, Portugal. Methods This was a retrospective analysis of patients submitted to Roux-en-Y gastric bypass (RYGB), laparoscopic adjustable gastric banding (LAGB), or sleeve gastrectomy (SG). Leukocyte and subset counts were compared between baseline and 1-year postsurgery and between BS types. A multivariate linear regression model was built to study determinants of leukocyte and subset variation. Results We analyzed 764 patients: 238 submitted to LAGB; 452 to RYGB, and 74 to SG. Mean age was 42 years and 86.6% were women. All BS types were associated with a decrease in leukocyte and neutrophil counts but the variation in body mass index and homeostatic model assessment (HOMA-IR) were the only variables independently associated with a decrease 1-year postsurgery. Monocytes increased in patients submitted to LAGB and decreased in those who underwent RYGB and SG. The BS type was independently associated with monocyte variation. Patients who underwent RYGB and SG had a decrease in monocyte counts of 77/µL and 62/µL, respectively, compared with LAGB. Conclusion Weight and insulin resistance are the main predictors of leukocyte and neutrophil variation after BS. The specific type of BS is a determinant of monocyte count variation independent of the amount of weight loss or the degree of insulin resistance improvement. [ABSTRACT FROM AUTHOR]

Introduction: While attending to higher education, multiple changes occur in the lives of young students. These changes make higher education students particularly more exposed and vulnerable to mental health problems, and therefore more likely to present suicidal behaviors. Objectives: The aim of this study was to assess suicidal ideation in higher education students, and its relationship with some psychosocial variables. Methods: Exploratory, quantitative and descriptive study, applied on a sample of 1074 students of a higher education institution in Portugal. Results: Some significant associations with suicidal ideation were found with self-concept factors (self-acceptance, self-effectiveness and impulsivity); stress, anxiety and clinical depression; linkage anxiety and social support activities dimensions; intimacy and total social support. Conclusion: In our sample we found 84 students with potential suicidal risk, and through the result analysis, the biopsychosocial profile of the student at risk for suicidal ideation exhibits the following traits: female, age 18/19, low self-concept, insecure linkage patterns and little involvement in social activities and intimacy relationships. All facts considered, higher education institutions should provide programs that promote mental health and suicide prevention in academic environments. The results of this study also have implications for policy makers, clinical practice, suicide prevention and higher education institutions. [ABSTRACT FROM AUTHOR]

Red table grapes were treated after harvest with ultraviolet-C light (UV-C) and chitosan coating, both alone and in combination. Effect of treatments on quality, fungal decay, and resveratrol content of grapes was studied. In preliminary trials, combination of UV-C with chitosan coating yielded better results compared with the same treatments applied alone. Therefore, further optimization was performed with combinations of the two treatments. Chitosan coating preserved brightness and visual quality of fruit while preventing decay by Botrytis cinerea . Furthermore, this coating treatment had no effect on respiration rate or resveratrol content of grapes. UV-C treatment combined with storage at 20 °C for 24 h before refrigerated storage led to increased resveratrol content and had no negative effects on the sensory quality of treated grapes when combined with chitosan coating. In contrast with endogenous resveratrol, the application of resveratrol solutions was effective for the prevention of growth of B. cinerea . Use of UV-C combined with chitosan coating followed by incubation for 24 h at 20 °C before refrigerated storage increased the resveratrol content, maintained sensory quality, and reduced fungal decay of red table grapes when compared to control grapes. [ABSTRACT FROM AUTHOR]

Abstract: Human immunodeficiency virus (HIV) infection and its treatment with antiretroviral therapy (ART) have been associated with lipodystrophy. Different clinical methodologies have been used to define the syndrome. The aim of this study was to propose gender-specific reference values using objective measurements for defining lipodystrophy in HIV-infected patients. Using dual-energy X-ray absorptiometry (DXA), total body composition was analyzed in 221 HIV-infected patients under ART (146 men). We used fat mass ratio (FMR) as the ratio between the percent of the trunk fat mass and the percent of the lower-limb fat mass. One hundred forty patients (63.6%) presented clinically defined lipodystrophy. In men, the optimal cutoff value for the FMR was 1.961 (area under the receiver operating characteristic curve [AUC]: 0.74 [95% confidence interval (CI): 0.66–0.82], p <0.001), with a sensitivity 58.3%, a specificity 83.7%, a positive predictive value (PPV) of 89.6% and a negative predictive value (NPV) of 45.5%. In women, the optimal cutoff value for the FMR was 1.329 (AUC: 0.74 [95% CI: 0.63–0.86], p <0.001), with a sensitivity 51.4%, a specificity 94.6%, a PPV of 90.5%, and an NPV of 66.0%. The FMR evaluated by DXA with the gender-specific cutoffs defined here is an objective way to define HIV-related lipodystrophy. [Copyright &y& Elsevier]

A 24-year-old white man, nonsmoker and nonalcoholic, presented to the stomatology ambulatory department with the complaint of desquamation on his lips that started 9 years ago. On intraoral examination, lesions were observed in all extension of the upper and lower lips, sometimes of yellowish color, sometimes whitish, with painless and crusted areas. He reported putting his lips between his teeth in a chronic way and a habit of nibbling. The patient performed previous topical treatments without resolution of the condition. After an incisional biopsy with results that showed an unspecific chronic inflammatory process and the associated clinical examination, the final diagnosis was factitious cheilitis. After diagnosis, manipulated topical treatment of 9 g Vaseline + 1 g lanolin + 2 g glycerin, in gel, was instituted for 2 months, and total lesion regression was observed. The patient has been followed up for 6 months, evolving with normal aspects in the labial mucosa. [ABSTRACT FROM AUTHOR]

A 62-year-old male patient with light brown skin color sought the stomatology clinic with complaint of cyst in the inferior alveolar ridge for 2 months without symptoms. Extraoral examination showed no alterations. Intraoral examination presented nodular sessile lesion with delimited boundary and the same color of the adjacent mucosa that measured approximately 10 mm in the left inferior alveolar ridge, on canine tooth area, without trauma history association. Periapical radiography was requested that evidenced a cup-shaped resorption area. With a diagnostic hypotheses of peripheral giant cell lesion and peripheral ossifying fibroma, an excisional biopsy was performed, and treatment of the bone resorption was started. The anatomopathologic analysis showed a fragment of cystic lesion coated by stratified squamous epithelium with arch projections, ghost cells, and amorphous lobular mass, confirming the diagnosis of peripheral calcifying odontogenic cyst. The patient remains on clinic and image control during 8 months without signs of recurrence. [ABSTRACT FROM AUTHOR]

Abstract: This study sought to determine independent predictors of all-cause mortality for patients with Chagas'' disease heart failure listed for heart transplantation. Need of inotropic support (p =0.01; hazard ratio=14.68, 95% Confidence Interval 1.86 to 115.82) and the Transpulmonary Gradient (p =0.02; HR=1.15, 95% Confidence Interval 1.03 to 1.30) were established independent predictors of all-cause mortality. [Copyright &y& Elsevier]

Abstract: We sought to determine clinical characteristics as well as outcome of angina-free patients with chronic ischemic heart failure. In comparison with ischemic chest pain patients, angina-free patients have higher heart rate and systolic blood pressure on admission, lower number of diseased coronary artery vessels at coronary arteriogram and higher survival probability. Thus, angina-free patients with ischemic heart failure have a distinctive clinical picture and a better outcome than ischemic chest pain patients with chronic heart failure. [Copyright &y& Elsevier]