We evaluated effects on cardiovascular disease (CVD) risk factors of a Mediterranean‐style, low glycemic load diet (MLGD) alone or in combination with a phytosterol‐soy based medical food (PSS) ...containing hops rho iso‐alpha acids and acacia proanthocyanidins in women with metabolic syndrome (MetS). Subjects (BMI 25–45 kg/m2, LDL cholesterol (LDL‐C) ≥100 mg/dL, and TG≥150 mg/dL) were randomly assigned to either MLGD+PSS (n=12) or MLGD alone (n=12). No caloric restriction was imposed and exercise was maintained at baseline levels. Improvements in total cholesterol, LDL‐C, and apolipoprotein B (apo B) were noted in both arms (P<0.01). ApoB/apo A1 and insulin were reduced only in MLGD+PSS (P<0.01). Compared to MLGD, MLGD+PSS experienced greater reductions (P<0.05) in apo B at 8 and 12 weeks and in homocysteine at 12 weeks (p<0.05). LDL particle number was decreased at 8 (P<0.005) and 12 weeks (P<0.05) in MLGD+PSS; however, a reduction was found only at 8 weeks (P<0.05) in MLGD. Small LDL particles were decreased at 8 weeks (P<0.005) and trended downward at 12 weeks (p=0.06) only in MLGD+PSS. A downward trend in hsCRP was noted at 12 weeks, only in MLGD+PSS (P=0.07). Supplementation with a medical food containing soy, phytosterols, and specific phytonutrients may enhance benefits of a MLGD in women with MetS leading to global improvement in multiple CVD risk factors.
Supported by MetaProteomics, LLC.
Abstract only
We analyzed the dietary records of 18 women (25‐61y) classified with the metabolic syndrome (MetS) with a mean body mass index of 31.8 ± 4.0 kg/m
2
to establish potential relationships ...between dietary intake, anthropometrics and plasma lipids in this population. The mean waist circumference was 101.4 ± 8.8 cm and mean plasma triglycerides were 193.5 ± 45.0 mg/dL. Plasma HDL cholesterol ranged from 23 to 76 mg/dL, blood pressure ranged from 100/70 to 150/90 mm Hg and plasma glucose from 66 to 129 mg/dL. We evaluated diet intake by using 3 day dietary records. Fiber intake was only 56% of the dietary recommendations and subjects were also consuming inappropriate levels of Vitamin D (‐40%), tocopherol (‐45%), ascorbic acid (‐12%), calcium (‐29%) magnesium (‐25%) and iron (‐29%). Waist circumference was positively correlated with energy intake (r = 0.647, P < 0.01), sugar intake (r= 0.547, P < 0.025) and added sugar (r = 0.654, P < 0.005). Intake of omega 3 fatty acids was inversely correlated with systolic blood pressure (r =‐0.475. P< 0.05) while dietary fiber intake was negatively associated with plasma LDL cholesterol (r=‐0.513, P < 0.05). The data suggest that in these women, sugar intake may contribute to the high waist circumference, a key parameter for MetS classification. In addition, it is clear that aside from the obesity problem, this population has poor dietary habits with major deficiencies in important micronutrients Supported by Metagenics, Inc, Gig Harbor, WA.
Background:
During screening for enrollment in a clinical trial, we noticed potential racial disparities in metabolic syndrome variables in women who responded to our study advertisement. We designed ...a nested observational study to investigate whether metabolic syndrome variables differed between non-Hispanic blacks and non-Hispanic whites.
Methods:
The cohort comprised of women who have met the preliminary clinical trial criteria (body mass index BMI 25—45, age 20—75 years, and no use of lipid-lowering medications or supplements). These women, including 116 blacks and 138 whites, provided fasting blood samples for analysis of serum lipid profile.
Results:
Blacks had lower mean triglycerides (81.1 ± 3.3 mg/dL vs 140.6 ± 5.9 mg/dL; P < .0001), total cholesterol (176.1 ± 3.6 mg/dL vs 201.6 ± 3.3 mg/dL; P < .0001), and low-density lipoprotein (111.7 ± 3.3 mg/dL vs 128.2 ± 2.9 mg/dL; P < .001) and higher mean BMI (37.2 ± 0.5 vs 35.2 ± 0.5; P < .01) and diastolic blood pressure (82.4 ± 0.8 mmHg vs 79.4 ± 0.7 mmHg; P < .01) than whites. Only 7% of blacks, compared with 41% of whites, had triglycerides ≥150 mg/dL; as a result, fewer black women met metabolic syndrome criteria than white women. Additionally, in women with waist circumference ≥88 cm (N = 215), high-density lipoprotein was higher in blacks than in whites (48.3 ± 1.5 mg/dL vs 44.2 ± 1.3 mg/dL; P < .05).
Conclusions:
Due to racial differences in blood lipids, current metabolic syndrome criteria may result in underestimation of cardiovascular risk in blacks.
Part A. A series of fluoroalkyl and alkyl 2,5-dichlorobenzoates were synthesized for future aryl chloride polymerization and to examine their supercritical solvent solubility. The fluorinated alkyl ...2,5-dichlorobenzoates investigated in this study is highly soluble in CO2 at modest conditions. The solubility of the hydrocarbon alkyl 2,5-dichlorobenzoates decreases significantly as the alkyl chain length increases. Alkyl and fluoroalkyl ester substituted poly(p-phenylene)s (PPP) were synthesized by aryl halide coupling using a nickel catalyst and zinc. The solubilities of the alkyl and fluoroalkyl PPPs were studied in supercritical solvents. The propyl, butyl, pentafluoropropyl, and heptafluorobutyl ester substituted PPPs were not soluble in sc-ethane, sc-propane, sc-butane, or SC-CO2 at high pressures and high temperatures. The pentyl, hexyl, and octyl ester substituted PPPs were soluble in sc-ethane, sc-propane, and sc-butane. A series of polymer analogues with H-H and T-T connectivities were synthesized in the form of dimers. The dimers included octyl and tridecafluorooctyl ester moieties. The dimers were synthesized because the polymer 1H NMR showed regioirregularities in the polymer backbone. A polymer study was initiated to attempt to increase the regioregularity in the aryl chloride coupling of alkyl and fluoroalkyl 2,5-dichlorobenzoates. The study was completed by varying the ligand (dppf, dppp, PPh3, or PPh3/bpy,) in the coupling reaction, using the hexyl, octyl, nonafluorohexyl, and tridecafluorooctyl 2,5-dichlorobenzoates. A completely regioregular polymer was not formed in the varying ligand study, therefore the regioregularity can not be generated from the nickel catalyst alone. The supercritical solubility of the biphenyl 2,3′-dicarboxylic acid dioctyl ester showed a ∼400 bar higher maximum pressure than the biphenyl-2,2′-dicarboxylic acid dioctyl ester. The biphenyl-2,3 ′-dicarboxylic acid di-tridecafluorooctyl ester showed a ∼50 bar higher maximum pressure than the biphenyl-2,2′-dicarboxylic acid di-tridecafluorooctyl ester. The T-T dimers displayed higher solubility than the H-H due to the ability of the T-T dimers to have a planar conformation. Part B. An azobenzene monomer with methoxy and hexyloxy substitutents were synthesized by a diazotination reaction of 3-bromo-4-methoxy phenol and 4-bromo aniline, and then alkylated with hexyliodide. The polymer was synthesized in a palladium-catalyzed reaction to yield the first conjugated organic polymer that contains an azo linkage in the backbone. The polymer exhibited excellent third-order nonlinear properties in THF. (Abstract shortened by UMI.)
Mt. Morris Twp.--The owner of an Owosso car parts factory that was destroyed by fire last year is hoping to open an auto-related facility on Clio Road that could employ 300 people. Donald Williamson, ...who owned The Colonel's plastic bumper plant in Owosso, is expected to present plans to the township Planning Commission next month for a factory that would produce plastic pickup truck bedliners. Williamson said the Colonel's Liners would be located on the former Blain Buick GMC property on Clio Road that he still owns. A 150,000-square-foot addition would be added to the 100,000-square-foot dealership for the factory, he said. (excerpt)
To compare the incidence and hazard of neuropsychiatric, musculoskeletal, and cardiometabolic conditions among adults with and without vision impairment (VI).
Retrospective cohort study.
The sample ...comprised enrollees in a large private health insurance provider in the United States, including 24 657 adults aged ≥18 years with VI and age- and sex-matched controls. The exposure variable, VI, was based on low vision and blindness International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification (ICD-9-CM and ICD-10-CM), diagnosis codes. Physician-diagnosed incident neuropsychiatric, musculoskeletal, and cardiometabolic diseases were identified using ICD codes. Separate Cox proportional hazards regression models were used to assess the association of VI with incidence of 30 chronic conditions, adjusting for Elixhauser Comorbidity Index. Analyses were stratified by age 18-64 years and ≥65 years.
In individuals with VI aged 18-64 years (n=7478), the adjusted hazard of neuropsychiatric (HR 2.1, 95% CI 1.9, 2.4), musculoskeletal (HR 1.8, 95% CI 1.7, 2.0), and cardiometabolic (HR 1.8, 95% CI 1.7, 2.0) diseases was significantly greater than in matched controls (mean 5.5 years follow-up). Similar associations were seen between patients with VI aged ≥65 years (n=17 179) for neuropsychiatric (HR 2.4, 95% CI 2.1, 2.7), musculoskeletal (HR 1.8, 95% CI 1.6, 1.9), and cardiometabolic (HR 1.7, 95% CI 1.4, 2.0) diseases. VI was associated with a higher hazard of each of the 30 conditions we assessed, with similar results in both age cohorts.
Across the life span, adults with VI had an approximately 2-fold greater adjusted hazard for common neuropsychiatric, musculoskeletal, and cardiometabolic disorders compared with matched controls without VI.
•Vision impairment was associated with an approximately 2-fold greater hazard for common chronic diseases.•Adults with vision impairment had a higher incidence of each of the 30 chronic conditions included in this analysis.•This analysis includes neuropsychiatric, musculoskeletal, and cardiometabolic disease outcomes.•These associations were similar in young to middle-age (18-64 years) and older (≥65 years) adults.
Objectives/Hypothesis
To evaluate whether antithrombotic status impacts the incidence of perioperative or postoperative bleeding in direct microlaryngoscopy (DML).
Study Design
Retrospective chart ...review.
Methods
Patients undergoing DML in a single surgeon's practice from September 2012 to September 2017 were studied. Included patients underwent DML with or without biopsy, balloon dilation, microsurgery, laser ablation, or vocal fold injection. Patients were stratified based on perioperative antithrombotic status and assessed for rates of peri‐ and postoperative bleeding and other complications.
Results
Of the 581 patients meeting inclusion criteria, 179 patients (31%) had a history of baseline antithrombotic therapy. Of these patients, 124 had perioperative continuation of their therapy. Medicated patients were older (P < .01), predominately male (P < .01), and increasingly comorbid (P < .01). Perioperative complications unrelated to bleeding occurred in 22 patients (4%), minor perioperative bleeding occurred in four patients (0.7%), and minor postoperative bleeding occurred in 12 of the 479 patients with recorded follow‐up (2.5%). There were no postoperative bleeds requiring intervention or readmission, and no recorded thrombotic events during the peri‐ and postoperative period. There was no difference in perioperative bleeding based on baseline antithrombotic status (P = .81). Patients on baseline antithrombotic therapy were more likely to have a postoperative bleed in comparison to patients without history of antithrombotic use (P < .01). However, there were no significant differences in postoperative bleeding between patients on baseline anticoagulation who continued or ceased their medication perioperatively (P = .45).
Conclusions
Perioperative continuation of antithrombotic medications appears to be safe when performing routine DML.
Level of Evidence
4 Laryngoscope, 2020
Abstract In the United States, estimates indicate there are between 250,000 and 400,000 individuals with Down syndrome (DS), and nearly all will develop Alzheimer's disease (AD) pathology starting in ...their 30s. With the current lifespan being 55 to 60 years, approximately 70% will develop dementia, and if their life expectancy continues to increase, the number of individuals developing AD will concomitantly increase. Pathogenic and mechanistic links between DS and Alzheimer's prompted the Alzheimer's Association to partner with the Linda Crnic Institute for Down Syndrome and the Global Down Syndrome Foundation at a workshop of AD and DS experts to discuss similarities and differences, challenges, and future directions for this field. The workshop articulated a set of research priorities: (1) target identification and drug development, (2) clinical and pathological staging, (3) cognitive assessment and clinical trials, and (4) partnerships and collaborations with the ultimate goal to deliver effective disease-modifying treatments.
During allogeneic hematopoietic cell transplantation (alloHCT), nonhematopoietic cell interleukin-33 (IL-33) is augmented and released by recipient conditioning to promote type 1 alloimmunity and ...lethal acute graft-versus-host disease (GVHD). Yet, IL-33 is highly pleiotropic and exhibits potent immunoregulatory properties in the absence of coincident proinflammatory stimuli. We tested whether peri-alloHCT IL-33 delivery can protect against development of GVHD by augmenting IL-33–associated regulatory mechanisms. IL-33 administration augmented the frequency of regulatory T cells (Tregs) expressing the IL-33 receptor, suppression of tumorigenicity-2 (ST2), which persist following total body irradiation. ST2 expression is not exclusive to Tregs and IL-33 expands innate immune cells with regulatory or reparative properties. However, selective depletion of recipient Foxp3+ cells concurrent with peri-alloHCT IL-33 administration accelerated acute GVHD lethality. IL-33–expanded Tregs protected recipients from GVHD by controlling macrophage activation and preventing accumulation of effector T cells in GVHD-target tissue. IL-33 stimulation of ST2 on Tregs activates p38 MAPK, which drives expansion of the ST2+ Treg subset. Associated mechanistic studies revealed that proliferating Tregs exhibit IL-33–independent upregulation of ST2 and the adoptive transfer of st2+ but not st2− Tregs mediated GVHD protection. In total, these data demonstrate the protective capacity of peri-alloHCT administration of IL-33 and IL-33–responsive Tregs in mouse models of acute GVHD. These findings provide strong support that the immunoregulatory relationship between IL-33 and Tregs can be harnessed therapeutically to prevent GVHD after alloHCT for treatment of malignancy or as a means for tolerance induction in solid organ transplantation.
•Peri-alloHCT IL-33 delivery prevents acute GVHD through MAPK-dependent expansion of radiation-resistant recipient ST2+ Tregs.•IL-33–expanded Tregs regulate myeloid cell differentiation and activation, and limit effector T-cell accumulation in GVHD-target tissue.
To estimate the hazard of incident idiopathic intracranial hypertension, a potentially blinding condition, among women using levonorgestrel intrauterine devices (LNG-IUD) compared to copper IUD, as ...conflicting associations have been reported.
This retrospective, longitudinal cohort study identified women ages 18-45 years in a large care network (January 1, 2001, to December 31, 2015) using LNG-IUD, subcutaneous etonogestrel implant, copper IUD, tubal device/surgery, or hysterectomy. Incident idiopathic intracranial hypertension was defined as the first diagnosis code for after 1 year without any codes and following brain imaging or lumbar puncture. Kaplan-Meier analysis estimated time-dependent probabilities of idiopathic intracranial hypertension at 1 and 5 years after incident contraception use, stratified by type. Cox regression estimated the hazard of idiopathic intracranial hypertension associated with LNG-IUD use compared to copper IUD (primary comparison) after adjusting for sociodemographics and factors associated with idiopathic intracranial hypertension (e.g., obesity) or contraception selection. A sensitivity analysis with propensity score-adjusted models was performed.
Of 268,280 women, 78,175 (29%) used LNG-IUD, 8715 (3%) etonogestrel implant, 20,275 (8%) copper IUD, 108,216 (40%) hysterectomy, 52,899 (20%) tubal device/surgery, and 208 (0.08%) developed idiopathic intracranial hypertension over a mean follow-up of 2.4 ± 2.4 years. Also, 1-/5-year Kaplan-Meier idiopathic intracranial hypertension probabilities were 0.0004/0.0021 for LNG-IUD and 0.0005/0.0006 for copper IUD users. LNG-IUD use did not show significantly different hazard of idiopathic intracranial hypertension compared to copper IUD (adjusted hazard ratio 1.84 95% CI 0.88, 3.85). Sensitivity analyses were similar.
We did not observe a significantly increased hazard of idiopathic intracranial hypertension among women using LNG-IUD compared to copper IUDs.
The lack of an association between LNG-IUD use and idiopathic intracranial hypertension in this large observational study provides reassurance to women considering initiation or continued use of this highly effective contraceptive method.
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