Non-alcoholic fatty liver disease in women with polycystic ovary syndrome: systematic review and meta-analysis.

PURPOSE: Non-alcoholic fatty liver disease (NAFLD) is an insidious pathologic condition that can manifest from simple steatosis to steatohepatitis (NASH) with potential progression to cirrhosis. Like the polycystic ovary syndrome (PCOS), NAFLD is associated with obesity, diabetes mellitus, insulin resistance and metabolic syndrome. PCOS women have an increased risk of NAFLD, but it is debatable which features of PCOS, either specific (androgen excess) or unspecific (metabolic derangements) affect the NAFLD risk. METHODS: We performed a systematic review and meta-analysis of studies that addressed the association of PCOS and NAFLD. We selected 17 studies published between 2007 and 2017 that included 2734 PCOS patients and 2561 controls of similar age and body mass index (BMI). RESULTS: PCOS patients have increased prevalence of NAFLD (odds ratio 2.54, 95% confidence interval 2.19-2.95). PCOS women with hyperandrogenism (classic phenotype) have a higher prevalence of NAFLD compared to women with PCOS without hyperandrogenism, even after correction for confounding variables. Among women with PCOS, those with NAFLD have higher serum total testosterone (mean difference 0.40 nmol/L, 95% CI 0.29-0.50 nmol/L) and free androgen index (mean difference 4.46, 95% CI 3.53-5.39) than those without NAFLD. The studies that used multivariate analysis controlling for age, BMI, triglycerides, and insulin resistance index confirmed that serum androgens are independent predictors of NAFLD in women with PCOS. CONCLUSION: The prevalence of NAFLD is increased in women with PCOS and the presence of NAFLD is associated with high serum androgen levels, in addition to obesity and insulin resistance.

Perfil hematológico de éguas Quarto de Milha alimentadas com feno ou haylage de Tifton-85 ( Cynodon spp. ) / Hematological panel of Quarter Horse mares fed Tifton 85 (Cynodon spp. ) hay and haylage

RESUMO O capim Tifton-85 (Cynodon spp.) vem sendo utilizado na alimentação de equinos na forma de pré-secado (haylage) e feno, todavia não existem estudos conclusivos a respeito da influência da haylage sobre o estado de saúde dessa espécie. Portanto, esta pesquisa objetivou avaliar o perfil sanguíneo como indicador de higidez de éguas Quarto de Milha alimentadas com haylage e feno de Tifton-85. A gramínea utilizada foi cortada com 30 dias de crescimento. Para produção da haylage, a planta cortada permaneceu no campo até atingir 70% de matéria seca, quando foi colhida. Foram utilizadas 12 éguas Quarto de Milha, com idade entre oito e 12 anos e com peso vivo médio inicial de 451,6kg. Os animais foram distribuídos aleatoriamente em dois grupos (n=6), sendo o grupo 1 alimentado com feno e o grupo 2 alimentado com haylage, por um período de 28 dias. Foram realizadas cinco coletas de sangue em intervalos de uma semana, para a determinação do perfil hematológico. Em relação ao eritrograma, observou-se discreta diminuição da concentração de hemoglobina, do hematócrito e do volume globular médio (VGM) em ambos os grupos. No leucograma, houve aumento dos leucócitos totais nas coletas iniciais em ambos os grupos, mas sem significado clínico. Conclui-se que éguas adultas Quarto de Milha, após a ingestão de feno e haylage de Tifton-85, não apresentaram alterações no perfil hematológico que indicassem prejuízos à saúde.(AU)

ABSTRACT Tifton-85 grass (Cynodon spp) has been used in equine nutrition in the form of pre-dried (haylage) and hay, however, there are no conclusive studies about the influence of haylage on blood profile of this species. Therefore, the aim of this study was to evaluate the blood profile as health indicators of Quarter Horse mares were fed haylage and Tifton-85 hay. The used grass was cut at 30 days of growth. For the production of haylage, this plant remained cut in the field until it had 70% of dry matter, when it was collected. Twelve Quarter Horse mares, aged 8-12 years, with average weight of 451.58kg were used. The animals were distributed randomly into two groups (n= 6), group 1 fed hay and group 2 fed haylage, both for 28 days. Blood samples were collected at one week intervals each for determining the hematological parameters. In the erythrogram, a decrease in the hemoglobin concentration, packed cell volume and mean cell volume after the administration in both groups were detected. The white blood count increased in both groups, but the values remained within normal limits without clinical significance. In conclusion, adult Quarter Horse mares fed Tifton-85 hay and haylage showed no alterations in hematology.(AU)

Prevalence of food allergy in infants and pre-schoolers in Brazil.

BACKGROUND: Food allergy is an increasing problem in public health, especially in childhood. Its incidence has increased in the last decade. Despite this, estimates of the actual incidence and prevalence are uncertain. The aim of this study was to estimate the prevalence of food allergy in infants and pre-schoolers. METHODS: The parents of 3897 children completed questionnaires on the occurrence of any reaction to food. Children with parentally reported reactions were selected for further examination including a clinical interview, physical examination, allergic tests, and if necessary, oral food challenge to conclude the diagnosis of FA. RESULTS: The estimated prevalence of allergy in children aged 4-59 months was 0.61%, being, 1.9% in infants and 0.4% in pre-schoolers. Among the 604 patients physicians evaluated with parent-reported FA, 24 (4%) had a confirmed diagnosis of food allergy, and 580 (96%) were excluded in the remaining. Of these, approximately half (51/52.6%) of 97 infants and (128/48%) of 487 pre-schoolers already performed the diet exclusion suspected food for a period of time. CONCLUSION: This study shows that high overall prevalence of parental belief of current food allergy however the same was not observed in the in physician-diagnosed food allergy. The prevalence of food allergy was lower than that observed in the literature. This study alerts health professionals to the risk entailed by overestimation of cases of food allergy and unnecessary dietary exclusion, which may result in impairment in growth and development of children, especially in their first years of life.

A randomised controlled trial of periconal eye blockade with or without ultrasound guidance.

We randomly allocated 129 participants with normal eyes to periconal blockade with (n = 69) or without (n = 60) ultrasound guidance before cataract surgery. There was no difference in the rates of complication, 1/69 and 0/60, respectively, p = 1.0. The rate of intraconal needle placement was 1/69 with ultrasound and 12/60 without ultrasound, a relative risk (95% CI) of 0.07 (0.01-0.55), p < 0.0001.

A safety and feasibility study of cell therapy in dilated cardiomyopathy

The aim of this study was to determine if bone marrow mononuclear cell (BMMC) transplantation is safe for moderate to severe idiopathic dilated cardiomyopathy (IDC). Clinical trials have shown that this procedure is safe and effective for ischemic patients, but little information is available regarding non-ischemic patients. Twenty-four patients with IDC, optimized therapy, age 46 ± 11.6 years, 17 males, NYHA classes II-IV, and left ventricular ejection fraction <35 percent were enrolled in the study. Clinical evaluation at baseline and 6 months after stem cell therapy to assess heart function included echocardiogram, magnetic resonance imaging, cardiopulmonary test, Minnesota Quality of Life Questionnaire, and NYHA classification. After cell transplantation 1 patient showed a transient increase in enzyme levels and 2 patients presented arrhythmias that were reversed within 72 h. Four patients died during follow-up, between 6 and 12 weeks after therapy. Clinical evaluation showed improvement in most patients as reflected by statistically significant decreases in Minnesota Quality of Life Questionnaire (63 ± 17.9 baseline vs 28.8 ± 16.75 at 6 months) and in class III-IV NYHA patients (18/24 baseline vs 2/20 at 6 months). Cardiopulmonary exercise tests demonstrated increased peak oxygen consumption (12.2 ± 2.4 at baseline vs 15.8 ± 7.1 mL·kg-1·min-1 at 6 months) and walked distance (377.2 ± 85.4 vs 444.1 ± 77.9 m at 6 months) in the 6-min walk test, which was not accompanied by increased left ventricular ejection fraction. Our findings indicate that BMMC therapy in IDC patients with severe ventricular dysfunction is feasible and that larger, randomized and placebo-controlled trials are warranted.

A safety and feasibility study of cell therapy in dilated cardiomyopathy.

The aim of this study was to determine if bone marrow mononuclear cell (BMMC) transplantation is safe for moderate to severe idiopathic dilated cardiomyopathy (IDC). Clinical trials have shown that this procedure is safe and effective for ischemic patients, but little information is available regarding non-ischemic patients. Twenty-four patients with IDC, optimized therapy, age 46 ± 11.6 years, 17 males, NYHA classes II-IV, and left ventricular ejection fraction <35% were enrolled in the study. Clinical evaluation at baseline and 6 months after stem cell therapy to assess heart function included echocardiogram, magnetic resonance imaging, cardiopulmonary test, Minnesota Quality of Life Questionnaire, and NYHA classification. After cell transplantation 1 patient showed a transient increase in enzyme levels and 2 patients presented arrhythmias that were reversed within 72 h. Four patients died during follow-up, between 6 and 12 weeks after therapy. Clinical evaluation showed improvement in most patients as reflected by statistically significant decreases in Minnesota Quality of Life Questionnaire (63 ± 17.9 baseline vs 28.8 ± 16.75 at 6 months) and in class III-IV NYHA patients (18/24 baseline vs 2/20 at 6 months). Cardiopulmonary exercise tests demonstrated increased peak oxygen consumption (12.2 ± 2.4 at baseline vs 15.8 ± 7.1 mL·kg⁻¹·min⁻¹ at 6 months) and walked distance (377.2 ± 85.4 vs 444.1 ± 77.9 m at 6 months) in the 6-min walk test, which was not accompanied by increased left ventricular ejection fraction. Our findings indicate that BMMC therapy in IDC patients with severe ventricular dysfunction is feasible and that larger, randomized and placebo-controlled trials are warranted.

American cutaneous leishmaniasis due to Leishmania (Viannia) guyanensis as an initial clinical presentation of human immunodeficiency virus infection.

The authors present the first report of Leishmania (Viannia) guyanensis (L.(V.) guyanenesis) associated with human immunodeficiency virus (HIV) in a Brazilian heterosexual man. It is also the first case of HIV infection associated with American cutaneous leishmaniasis in Brazilian Western Amazonia. The patient had cutaneous and mucous lesions with a negative Montenegro skin test. Histopathology showed large numbers of amastigotes, even in a lesion which had clinically healed. L.(V.) guyanenesis was typed by an immunoenzymatic technique. Various therapies were attempted, but the patient relapsed after each episode of treatment.