Flavanols are potential anti-obesity agents, a systematic review and meta-analysis of controlled clinical trials

BACKGROUND

The anti-obesity potential of flavonoids has been shown by animal and human studies. In this meta-analysis, we systematically reviewed controlled clinical trials and quantified the effects of flavonoids and flavonoid subclasses on obesity-related anthropometric measures.

METHODS AND RESULTS

PubMed, EMBASE, Scopus, Web of Science, and ProQuest databases were searched to identify trials examining the effect of flavonoids on body mass index (BMI), waist circumference, and body fat percentage. Fifty eight trials passed the eligibility process. Analysis endpoints were calculated as the mean difference between baseline and post-treatment. Flavonoids were in subclasses of flavanols, flavonols, isoflavones, flavanones, anthocyanins, and proanthocyanidins. They were mostly in the form of supplements and dosages varying from 40 to 1300 mg/day. Among flavonoid subclasses, flavanols showed potential for decreasing BMI, in the overall population (mean difference (MD) = -0.28 kg/m², P = 0.04; n = 21) and in the subgroups of Asians (MD = -0.42 kg/m²; P = 0.046; n = 13), ages < 50 years (MD = -0.50 kg/m²; P = 0.008; n = 14), BMI ≥ 25 kg/m² (MD = -0.30 kg/m²; P = 0.049; n = 15), and at doses ≥ 500 mg/day (MD = -0.36 kg/m²; P = 0.049; n = 12). Isoflavones also decreased BMI of non-Asian populations (MD = -0.26 kg/m²; P = 0.035; n = 13) and doses ≥ 75 mg/day (MD = -0.34 kg/m²; P = 0.027; n = 8). In the overall assessment, flavanols also decreased waist circumference (MD = -0.60 cm; P = 0.02; n = 18) but had no significant effect on body fat percentage. The available trials did not reveal significant effects from flavonols, flavanones, and anthocyanins on the specified anthropometric measures.

CONCLUSIONS

Overall results of this meta-analysis showed that flavanols have potential against obesity.

Acute vision loss in systemic lupus erythematosus: bilateral combined retinal artery and vein occlusion as a catastrophic form of clinical flare

Presentation of a combination of branch retinal artery occlusion (BRAO)/central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO) in systemic lupus erythematosus (SLE) is extremely rare. Herein, we have presented the case of a 29-year-old female with SLE, who simultaneously developed bilateral CRVO and BRAO/CRAO in the absence of antiphospholipid syndrome (APS) as a catastrophic form of clinical flare. A combinatorial diagnosis of CRVO and BRAO/CRAO should be considered during clinical flare-up in a patient with SLE who presents with rapidly progressive visual loss.

[201Tl](III)-bleomycin for tumor imaging

Due to interesting physical properties and wide availability of thallium-201 as a SPECT radionuclide, the idea of incorporation of this nuclide into biologically active compounds was targeted. Thallium-201 (T 1/2 = 3.04 d) in Tl+ form was converted to Tl3+ cation in presence of O3 in 6 M HCl controlled by RTLC/gel electrophoresis methods. The final evaporated activity was reacted with bleomycin in normal saline to yield [201Tl]BLM at room temperature after 0.5 h (radiochemical yield > 99%) followed by HPLC analysis. The studies showed that thallic ion is mostly incorporated into bleomycin A2 while other species in the pharmaceutical sample almost remain unlabeled. Radiochemical purity of more than 99% was obtained using RTLC, HPLC with specific activity of about 7 Ci/mmol. The stability of the tracer was checked in the final product in presence of human serum at 37 °C up to 3 d. The tracer accumulated in tumors of fibrosarcoma-bearing mice after 72 h.

Barriers and reinforcing factors to self-management behaviour in rheumatoid arthritis patients: A qualitative study

OBJECTIVE

The aim of the present study was to explore the view of rheumatoid arthritis (RA) patients about the barriers and reinforcing factors in practising self-management behaviour (SMB).

METHODS

This was a qualitative study based on directed content analysis of in-depth semi-structured interviews with 30 patients. The participants were selected using a purposeful sampling approach. The interviews continued until data saturation was reached. The study was conducted over 6 months in 2014-2015 at the Rheumatology Clinic of Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

RESULTS

Three main themes and 14 subthemes were extracted. The main themes included behavioural barriers, environmental barriers and reinforcing factors. The subthemes included lack of awareness; poor physician-patient relationship; lack of motivation; negative attitude and willingness; lack of time; cost; housing conditions and in-home equipment; negative social effects; social support; consequences of SMB; and comparing yourself with others.

CONCLUSION

Behavioural and environmental barriers, as well as social support and outcomes of SMB were the most important barriers and reinforcing factors of SMB. Therefore, considering these factors in patients may help in designing programmes that attempt to reduce barriers and increase reinforcing factors, which ultimately result in higher levels of SMB and quality of life among patients.

Preparation and evaluation of [67Ga]-DTPA-β-1–24-corticotrophin in normal rats

β-1–24-corticotrophin was successively labeled with [67Ga]-gallium chloride after residulation with freshly prepared cyclic DTPA-dianhydride. The best results of the conjugation were obtained by the addition of 1 ml of a β-1–24-corticotrophin pharmaceutical solution (1 mg/mL, pH=6.5) to a glass tube pre-coated with DTPA-dianhydride (0.01 mg) at 25 °C with continuous mild stirring for 30 min. Radio-thin layer chromatography showed an overall radiochemical purity of >90% at optimized conditions after labeling. HPLC showed a radiochemical purity more than 95% (specific activity =300–500 MBq/mg, labeling efficiency 77%). The stability of the radioconjugate was tested in presence of human serum at 37 °C. Preliminary in vivo studies in normal rats were performed to determine the biodistribution of the radioimmunoconjugate up to 30 min. Lungs showed to have the major tracer uptake which is consistent with the natural distribution of ACTH receptors in human body. Pretreatment of animals with cold peptide following labeled compound administration reduced lung uptake at least 10 and 3 times after 15 and 30 min, respectively, as well as significant decrease in adrenal uptake after 15 min. These data support the specific receptor binding of the radiolabeled compound. This tracer can be used in detection of ACTH receptor in lung and adrenal malignancies.

Endogenous Klebsiella endophthalmitis associated with liver abscess: first case report from iran

PURPOSE

To report the first case of endogenous Klebsiella endophthalmitis associated with liver abscess in Iran.

CASE REPORT

A 79-year-old man was referred to our hospital due to severe pain and visual loss in the left eye. On physical examination, conjunctival hyperemia, corneal edema, hypopyon and severe vitreous cellular reaction were identified in the left eye; however, yellowish conjunctival discoloration was more apparent in the right eye. Abdominal CT scan showed a right liver lobe abscess that was confirmed by sonographically guided percutaneous liver mass biopsy. Blood, vitreous and liver mass aspirate cultures revealed Klebsiella pneumoniae growth. The patient was thus diagnosed with endogenous Klebsiella endophthalmitis secondary to bacteremia associated with liver abscess.

CONCLUSION

This report suggests that, rather than being confined to Taiwan, endogenous endophthalmitis secondary to a liver abscess due to K. pneumoniae may be a global problem. Therefore, physicians should be aware of the possibility of endophthalmitis whenever a patient with K. pneumoniae liver abscess complains of ocular symptoms.

Molecular and clinical evidence of Aeromonas hydrophila and Fusarium solani co-infection in narrow-clawed crayfish Astacus leptodactylus

Co-infections occur when a host is infected by 2 or more different pathogen types, either by secondary or simultaneous infections, and are very frequent in nature. In this study, 10 narrow-clawed crayfish Astacus leptodactylus with signs of disease were collected from Haft Baram Lake (Fars province, southern Iran). Samples of fluid from inside the intact abscess and melanized lesions in the cuticle were cultured aseptically onto brain heart infusion agar and Sabouraud dextrose agar for bacterial and fungal agents, respectively. After primary colony isolation for bacterial and fungal agents, the isolates were confirmed as Aeromonas hydrophila and Fusarium solani, using specific PCR methods based on 16S rDNA and internal transcribed spacer (ITS) rDNA sequences that produced a single band of 685 bp and 600 bp, respectively. Partial sequence analysis of the F. solani ITS showed 100% sequence identity among all our samples, as well as a close genetic relationship between this isolate (GenBank accession number MG519784) and those previously reported from loggerhead sea turtle Caretta caretta in Cape Verde (FJ948133, AM412641, and DQ535186), black-blotched stingray Taeniura melanopsila in Japan (LC019016), and American manatee Trichechus manatus in Japan (AB775569). The results indicate that narrow-clawed crayfish can be infected by A. hydrophila and F. solani simultaneously, and to the best of our knowledge, this is the first report of just such a co-infection in this host. Further studies are necessary to investigate the pathogenicity of these organisms and their effects on narrow-clawed crayfish.

Oxygen saturation improvement after adenotonsillectomy in children

The goal of this study was to establish whether adenotonsillectomy is effective on the severity of oxygen desaturation or improve oxygen saturation in children with sleep breathing disorders. Thirty-two children, aged 4-7 years, with clinical indication for adenotonsillectomy were enrolled in a non-controlled clinical trial. Pre- and postoperative nocturnal oxygen saturation monitoring was done and oxygen desaturation index as well as desaturation events were analyzed using Wilcoxon and paired Student's t-tests. Snoring was the most prevalent (87.5%) complaint before operation. The study revealed a significant improvement in the postoperative oxygen desaturation index (1.60 +/- 3.22) compared with the preoperative oxygen desaturation index (3.98 +/- 4.93) (p < 0.01). Oxygen desaturation events at the level of oxygen saturation 85-89% was significantly improved after operation (p < 0.01). No significant differences were seen in the desaturation events at the levels of oxygen saturation lower than 85%. Nocturnal oxygen saturation improves mildly after adenotonsillectomy in children with sleep breathing disorders.

Special position for the anaesthetic management of a patient with giant neck and back masses

A neck mass is a risk factor for difficult airway during induction of anaesthesia particularly when accompanied with a giant back mass which limits positioning of the patient in the supine position. We report the management of a young woman with known recurrent neurofibroma scheduled for resection of her giant neck and back masses. Unfortunately, her dorsal thoracic mass was too huge to allow adoption of the supine position for induction of anaesthesia. In order to achieve a suitable supine position which is fundamental during airway management, we created a hole in the operating table to fit her giant back mass. Exhibition of this special operating table may help to achieve a suitable position and ease airway management which is not possible with routine tables in cases with giant posterior masses.

Determination of [201Tl]Tl(III) in [201Tl]TlCl solutions using HPLC

A high-performance liquid chromatography technique has been presented to measure the [(201)Tl]TlCl(3) impurity in [(201)Tl]TlCl radiopharmaceutical for precise determination of radiochemical purity. Diethylene tetraamine pentaacetic acid (DTPA) has been used for complete complexation of [(201)Tl]Tl(III). [(201)Tl]Tl(III)-DTPA was analyzed in the presence of [(201)Tl]Tl(I) using a cation exchange HPLC column.

Clinical evaluation of repeated propofol total intravenous anesthesia in dog

This current study designed to evaluate any possible changes in required doses and other cardiopulmonary findings after repeated propofol total intravenous anesthesia (TIVA) in dog. The study was conducted in 6 healthy sheepdogs, weight between 16.5 and 28 kg. Anaesthesia induced by 8 mg kg(-1) of propofol and maintained by continuous propofol (0.3 mg/kg/min) infusion in saline solution. All dogs received three times of propofol anaesthesia with the same protocol in a cross over design. As the animals in first, second and third time of anaesthesia allocated into groups 1, 2 and 3, respectively. Heart Rate (HR), rectal temperature (Temp), blood oxygen saturation (SpO2) by pulse oximetry and non invasive arterial blood pressures were measured. Times to the first swallowing attempt, ability to lift the head and standing were measured during recovery. The apnea was recorded in all animals but no significant difference was recorded between groups under study. Calculated doses of induction were sufficient for intubation of the animals. The average doses foe maintenance of anesthesia did not show any significant difference between groups under study. There were no significant differences found between groups in any comparable parameter. Despite of longer recovery time in group three, there were no significant differences between the Groups in different recovery times. Repeated propofol anesthesia did not improve resistance and respiratory changes in this species. However, some effects on blood pressure may happen without any effect on heart rate.

Tissue distribution of infectious pancreatic necrosis virus serotype Sp in naturally infected cultured rainbow trout, Oncorhynchus mykiss (Walbaum): an immunohistochemical and nested-PCR study

This study investigates the occurrence and distribution pattern of infectious pancreatic necrosis virus (IPNV) within the pancreas, liver, kidney and spleen of naturally infected cultured rainbow trout, Oncorhynchus mykiss (Walbaum), using immunohistochemistry (IHC). A nested PCR was also employed to confirm the presence of the virus in the pooled tissues of the specimens. All the examined tissues except spleen were immunohistochemically positive for IPNV, but staining intensity and distribution pattern varied. The kidney tubules had the most intense and widespread staining by IHC, indicating a specific tissue tropism at least for this particular serotype. The nucleotide sequence had the greatest identity with the Sp serotype confirming the presence of the nucleic acid of IPNV in the pooled tissues. Based on the present findings, it could be concluded that the absence of lesions consistent with infectious pancreatic necrosis (IPN) disease in the H&E-stained sections cannot rule out the presence of the IPNV, and the use of an alternative rapid confirmatory method such as IHC with formalin-fixed, paraffin-embedded tissue sections is helpful for the final diagnosis of IPN in rainbow trout.

Author Correction: Nearly all the sky is covered by Lyman-α emission around high-redshift galaxies

Change history: In this Letter, author M. Akhlaghi should be associated with affiliation (2) rather than (3). This error has been corrected online.

Fermentative H2 production from food waste: Parametric analysis of factor effects

Factorial fermentation experiments on food waste (FW) inoculated with activated sludge (AS) were conducted to investigate the effects of pH and the inoculum-to-substrate ratio (ISR [g VS_AS/g TOC_FW]) on biohydrogen production. The two parameters affected the H₂ yield, the fermentation rate and the biochemical pathways. The minimum and maximum yields were 41 L H₂/kg TOC_FW (pH = 7.5, ISR = 1.74) and 156-160 L H₂/kg TOC_FW (pH = 5.5, ISR = 0.58 and 1.74). The range of carbohydrates conversion into H₂ was 0.37-1.45 mol H₂/mol hexose, corresponding to 9.4-36.2% of the theoretical threshold. A second-order predictive model for H₂ production identified an optimum region at low pHs and high ISRs, with a theoretical maximum of 168 L H₂/kg TOC_FW at pH = 5.5 and ISR = 1.74. The Spearman's correlation method revealed several relationships between the variables, suggesting the potentially governing metabolic pathways, which turned out to involve both hydrogenogenic pathways and competing reactions.

The dietary wood betony, Stachys lavandulifolia Vahl extract as a growth promoter and immune enhancer in common carp (Cyprinus carpio)

The present study was conducted to evaluate the efficacy of wood betony (WB), Stachys lavandulifolia extract on growth performance and some immune responses in common carp, Cyprinus carpio. Different concentrations of the WB extract 0, 2, 4 and 8% (g per 100 g of diet) were added to commercial diet. Each treatment was randomly assigned to triplicate groups of fish having average initial weight of 44 ± 0.62 g for 10 weeks. The results showed that final weight, food conversion ratio, specific growth rate and condition factor were significantly improved by WB in a dose dependent manner, where the best growth parameters were achieved in the group of fish receiving the highest concentration of WB (P<0.05). Feeding fish at 2 and 4% W/W by WB in the diet improved lysozyme activity, ACH50 and IgM levels significantly in comparison to the control (P<0.05). Group of fish fed on 4% WB in the diet had the best levels of the immune characteristics (P<0.05). Based on the results of this study, it is recommended to feed common carp with WB to improve growth and non-specific immunity.