Long-term effects of low glycemic index/load vs. high glycemic index/load diets on parameters of obesity and obesity-associated risks: a systematic review and meta-analysis

AIM

The aim of the present meta-analysis was to investigate the long-term effects of glycemic index-related diets in the management of obesity with a special emphasis on the potential benefits of low glycemic index/load (GI/GL) in the prevention of obesity-associated risks.

DATA SYNTHESIS

Electronic searches for randomized controlled trials (RCTs) comparing low glycemic index/load versus high glycemic index/load diets were performed in MEDLINE, EMBASE and the Cochrane Library. Outcome of interest markers included anthropometric data as well as biomarkers of CVD and glycemic control. Study specific weighted mean differences were pooled using a random effect model. 14 studies were included in the primary meta-analysis. Weighted mean differences in change of C-reactive protein [WMD: -0.43 mg/dl, (95% CI -0.78 to -0.09), p = 0.01], and fasting insulin [WMD: -5.16 pmol/L, (95% CI -8.45 to -1.88), p = 0.002] were significantly more pronounced in benefit of low GI/GL diets. However decrease in fat free mass [WMD: -1.04 kg (95% CI -1.73 to -0.35), p = 0.003] was significantly more pronounced following low GI/GL diets as well. No significant changes were observed for blood lipids, anthropometric measures, HbA1c and fasting glucose. Sensitivity analysis was performed for RCTs excluding subjects with type 2 diabetes. Decreases in C-reactive protein and fasting insulin remained statistically significant in the low GI/GL subgroups.

CONCLUSIONS

The present systematic review provides evidence for beneficial effects of long-term interventions administering a low glycemic index/load diet with respect to fasting insulin and pro-inflammatory markers such as C-reactive protein which might prove to be helpful in the primary prevention of obesity-associated diseases.

Evaluation of Mucin-1 protein and mRNA expression as prognostic and predictive markers after neoadjuvant chemotherapy for breast cancer

BACKGROUND

Mucin-1 (MUC1) is a promising antigen for the development of tumor vaccines. We evaluated the frequency of MUC1 expression and its impact on therapy response and survival after neoadjuvant chemotherapy for breast cancer.

PATIENTS AND METHODS

Pre-treatment core biopsies of patients from the GeparTrio neoadjuvant trial (NCT 00544765) were evaluated for MUC1 by immunohistochemistry (IHC; N = 691) and quantitative RT-PCR (qRT-PCR; N = 286) from formalin-fixed paraffin-embedded (FFPE) samples.

RESULTS

MUC1 protein and mRNA was detectable in the majority of cases and was associated with hormone-receptor-positive status (P < 0.001). High MUC1 protein and mRNA expression were associated with lower probability of pathologic complete response (P = 0.017 and P < 0.001) and with longer patient survival (P = 0.03 and P < 0.001). In multivariable analysis, MUC1 protein and mRNA expression were independently predictive (P = 0.001 and P < 0.001). MUC1 protein and mRNA expression were independently prognostic for overall survival (P = 0.029 and P = 0.015).

CONCLUSIONS

MUC1 is frequently expressed in breast cancer and detectable on mRNA and protein level from FFPE tissue. It provides independent predictive information for therapy response and survival after neoadjuvant chemotherapy. In clinical immunotherapy trials, MUC1 expression may serve as a predictive marker.

Influence of the Cross-sectional Geometry on Wettability and Cleanability of Polyester Woven Fabrics

Filament cross-sections used in textiles and composites are becoming more and more complex. The type of cross-sectional shape impacts filament properties and are therefore, yarn and fabric characteristics. In this paper, the influence of different filament cross-section geometry on fibre properties as well as on fabric surface characteristics was studied. PET (polyethylene terephthalate) filament yarns made from two different cross-sectional shaped filaments, round and cruciform, were manufactured by the melt spinning process. Polyester fabrics were manufactured in a needle band weave machine from these two types of filament yarns. Topographic characteristics of polyester fabrics manufactured were determined by an imaging instrument for optical roughness analysis based on the principle of chromatic aberration. Differences between soiling behaviour, cleanability and wettability of the fabrics were revealed and discussed.

Digitized charge transfer magnitude determined by metal-organic coordination number

Well-ordered metal-organic nanostructures of Fe-PTCDA (perylene-3,4,9,10-tetracarboxylic-3,4,9,10-dianhydride) chains and networks are grown on a Au(111) surface. These structures are investigated by high-resolution scanning tunneling microscopy. Digitized frontier orbital shifts are followed in scanning tunneling spectroscopy. By comparing the frontier energies with the molecular coordination environments, we conclude that the specific coordination affects the magnitude of charge transfer onto each PTCDA in the Fe-PTCDA hybridization system. A basic model is derived, which captures the essential underlying physics and correlates the observed energetic shift of the frontier orbital with the charge transfer.

Reversible chiral switching of bis(phthalocyaninato) terbium(III) on a metal surface

We demonstrate a reversible chiral switching of bis(phthalocyaninato) terbium(III) molecules on an Ir(111) surface by low temperature scanning tunneling microscopy. With an azimuthal rotation of its upper phthalocyanine ligand, the molecule can be switched between a chiral and an achiral configuration actuated by respective inelastic electron tunneling and local current heating. Moreover, the molecular chiral configuration can be interchanged between left and right handedness during the switching manipulations, thereby opening up potential nanotechnological applications.

Molecular Kondo chain

An important development in recent synthesis strategies is the formation of electronically coupled one and two-dimensional organic systems for potential applications in nanoscale molecule-based devices. Here, we assemble one-dimensional spin chains by covalently linking basic molecular building blocks on a Au(111) surface. Their structural properties are studied by scanning tunneling microscopy and the Kondo effect of the basic molecular blocks inside the chains is probed by scanning tunneling spectroscopy. Tunneling spectroscopic images reveal the existence of separate Kondo regions within the chains while density functional theory calculations unveil antiferromagnetic coupling between the spin centers.

Stented bioprostheses in aortic position

INTRODUCTION

Biological stented prostheses are currently the main type of prosthetic valve used for aortic valve replacement. The ratio of bioprotheses to mechanical prostheses has switched in the last 15 years; the percentage of biological  prostheses implanted has risen from 30 % to 85 %. Moreover the total number of implanted stented bioprostheses remained stable over the last years despite competing procedures like stentless prostheses or transcatheter aortic valve implantation.

METHODS

A literature search of all published aortic valve replacement studies was performed from January 2000 through May 2012.

RESULTS

The recommendations guiding the type of heart valve replacement have been revised in recent years. Of particular interest are the new generation of biological prostheses with extended durability, a decrease in mortality of reoperation and an increase in life expectancy. Comorbidities such as chronic renal insufficiency or chronic atrial fibrillation are no longer contraindications to bioprostheses.

CONCLUSION

Overall, even in face of more innovative biological alternatives the implantation of stented bioprostheses is still a very interesting option and represents actually the most frequent valve implantation technique for aortic stenosis.

Effects of monounsaturated fatty acids on cardiovascular risk factors: a systematic review and meta-analysis

The appropriate pattern of macronutrient distribution for dietary protocols aimed at treating or preventing obesity and its associated cardiovascular diseases is still a controversial topic of discussion. Recommendations considering a specific percentage or range for monounsaturated fatty acids (MUFA) are rare. It was the aim of this study to analyze long-term, randomized, controlled dietary intervention trials and to investigate the effects of MUFA on the biomarkers of obesity and cardiovascular risk factors. Dietary regimens with a high amount of MUFA (>12%) were compared to those with ≤12%. The biomarkers taken into account were weight, waist circumference, fat mass, total cholesterol, LDL cholesterol, HDL cholesterol, triacylglycerols, systolic and diastolic blood pressure, as well as C-reactive protein. A total of 12 studies met the inclusion criteria. Data analysis was performed using the Review Manager 5.0.25 software. Significant differences between high- and low-MUFA protocols could be observed with respect to fat mass [-1.94 kg (confidence interval -3.72, -0.17), p = 0.03], systolic blood pressure [-2.26 mm Hg (confidence interval -4.28, -0.25), p = 0.03] and diastolic blood pressure [-1.15 mm Hg (confidence interval -1.96, -0.34), p = 0.005] favoring the dietary protocols with >12% MUFA. Therefore, MUFA might represent a useful tool in the design of dietary regimens for obesity and cardiovascular disease.

[New approaches to the monitoring of hospital hygiene: assessment of hygiene skills of staff members by structured interviews and observation]

INTRODUCTION

Increasing demands on hygiene in hospitals require improved methods of systematic monitoring by the Public Health Service.

METHODS

The hygiene skills of at least 20% of the hospital physicians and nurses were evaluated by structured interviews and observation. The results were presented to the hospitals.

RESULTS

In total, 184 persons were reviewed in 5 hospitals. On average, 7 out of 10 questions on hygiene knowledge were answered correctly, 74% of the persons asked demonstrated proper hand hygiene and 66% of them were not wearing any jewellery on their hands. There were no significant differences between physicians and nurses. The slight differences between the 5 hospitals were transferred into a ranking.

CONCLUSIONS

The application of the method provides additional information on hygiene in hospitals and allows a comparison of the hygiene skills of their staff members. The results form the basis for a dialogue between hospital and Public Health Service.

Responsiveness of adjacent ductal carcinoma in situ and changes in HER2 status after neoadjuvant chemotherapy/trastuzumab treatment in early breast cancer: Results from the GeparQuattro study (GBG 40)

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Background: Adjacent ductal carcinoma in situ (DCIS) is in found in approximately 45% of invasive ductal carcinomas (IDC) of the breast. Pure DCIS overexpresses HER2 in approximately 45%. There is uncertainty whether adjacent DCIS impacts on the response to neoadjuvant chemotherapy and trastuzumab as well as whether HER2 expression in IDC component or adjacent DCIS changes throughout treatment.

Methods: Core biopsies and surgical tissue from participants of the GeparQuattro study with HER2-positive IDC were centrally examined for the area of invasive ductal component and adjacent DCIS before and after receiving neoadjuvant anthracycline-taxane-trastuzumab containing chemotherapy. HER2 overexpression in IDC and adjacent DCIS was quantified separately by immunohistochemistry using the Ventana automated staining system. Pathological complete response (pCR) was defined as no residual invasive or non-invasive tumor tissue.

Results: Fifty nine (37.3%) of 158 IDCs presented with adjacent DCIS at diagnosis. These tumors showed lower regression grades than pure IDC (p=0.033). Presence of adjacent DCIS was an independent negative predictor of pCR (odds ratio 0.42 [95% CI 0.2-0.9], p=0.027). Adjacent DCIS area decreased from pre-treatment to surgery (r=0.205) with 30 (50.8%) IDCs with adjacent DCIS showing complete eradication of adjacent DCIS. HER2 status of adjacent DCIS was highly correlated with HER2 status of IDC component before (r=0.892) and after treatment (r=0.676). Degree of HER2 overexpression of the IDC component decreased in 16 (33.3%) out of 49 patients without a pCR. These 16 IDCs showed lower RGs compared to the 33 IDCs with unchanged HER2 expression (p=0.055).

Conclusions: HER2-positive IDCs with adjacent DCIS is less responsive to neoadjuvant chemotherapy and trastuzumab compared to pure IDC. However, complete eradication of adjacent DCIS is frequently observed. HER2-overexpression of the invasive ductal component decreases in a subset of tumors, which showed less tumor regression.