Effectiveness of Health Action Interventions in Enhancing Diet Quality and Glycemic Control Among Individuals With Type 2 Diabetes Mellitus: A Systematic Review of Randomized Clinical Trials.

CONTEXT: Diet quality is directly related to glycemic control in individuals with type 2 diabetes mellitus (T2DM). The use of dietary indices can provide a comprehensive understanding of the relationship between diet quality and clinical outcomes. OBJECTIVE: The aim was to evaluate the relationship between diet quality, measured using dietary indices, and its impact on improving glycemic control in individuals with T2DM through health interventions. DATA SOURCE: This study was conducted using 6 databases, including Web of Science, MEDLINE (via PubMed), Embase, Bireme, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL), as well as the gray literature (Google Academic). DATA EXTRACTION: Randomized clinical trials that evaluated the effectiveness of health interventions in adult and older adult individuals with T2DM and presented data on diet quality evaluated using dietary indices and the percentage of glycated hemoglobin (%HbA1c) were included. DATA ANALYSIS: A total of 3735 articles were retrieved, 4 of which were included in the study selection stages. The quality indices assessed in the studies were the Alternate Healthy Eating Index (AHEI), Healthy Eating Index-2010 (HEI-2010), Diet Quality Index-International (DQI-I), and Diet Quality Index-Revised (DQI-R). A reduction in %HbA1c was observed in 2 studies, which correlated with the AHEI and DQI-I scores in the intervention groups. The approach of using food labels to improve diet quality reduced %HbA1c by 0.08% in the intervention group compared with the control group. Only 1 study found no significant association between the DQI-R index and %HbA1c. Additionally, negative correlations were observed between body weight and the AHEI and DQI-I scores. CONCLUSION: Health interventions improved diet quality, glycemic control, and weight loss in individuals with T2DM. SYSTEMATIC REVIEW REGISTRATION: PROSPERO no. CRD42023430036.

Epigenetic Immune Cell Counting to Analyze Potential Biomarkers in Preterm Infants: A Proof of Principle in Necrotizing Enterocolitis.

Epigenetic immune cell counting is a DNA (de)methylation-based technique which can be used to quantify lymphocyte subsets on dried blood spots (DBS). The foregoing techniques allow for a retrospective investigation of immune cell profiles in newborns. In this study, we used this technique for determining lymphocyte subcounts as a potential biomarker for necrotizing enterocolitis (NEC). We investigated whether this technique can be implemented in the field of neonatology, by testing whether regulatory T cell (Treg) levels are pre-existently low in preterms with NEC. Newborn screening (NBS) cards from 32 preterms with NEC and 32 age- and weight-matched preterm controls, and 60 healthy term newborns, were analyzed. Relative and absolute cell counts were determined for CD3+, CD4+, CD8+, Th17, and Treg T cells. For both relative and absolute cell counts of CD3+, CD4+, CD8+, and Th17 T cells, significant differences were found between healthy term controls and both preterm groups, but not between preterm groups. For Tregs, no significant differences were found in either relative or absolute counts between any of the newborn groups. This study demonstrates the principle of epigenetic immune cell counting to analyze lymphocyte subsets in preterm neonates.

Regulatory T Cells in Development and Prediction of Necrotizing Enterocolitis in Preterm Neonates: A Scoping Review.

Necrotizing enterocolitis (NEC) is a leading cause of mortality in premature infants. However, the pathophysiology and influence of regulatory T cells (Tregs) have not been sufficiently elucidated. We performed a scoping review to investigate current knowledge on the influence of Tregs in NEC, and to investigate the predictive value of Treg number in NEC development. Pubmed, Embase, Prospero and Cochrane Library were searched during December 2020. Primary research articles discussing Tregs and NEC development written in English were selected. Two reviewers screened title and abstract for relevance, after which full-text screening was performed. A total of 20 articles were selected-13 of the articles discussed studies performed in animal models, while 8 used human neonate data. One study discussed both animal and human data. It was shown that after NEC diagnosis or induction, Treg levels were decreased while Th17 levels were increased. No studies were found which investigated the predictive value of Treg number in NEC development. A reduced Treg level is found in animals and neonates with NEC. The question remains whether this effect is a factor on the causal pathway of NEC development or a bystander effect. Future research focusing on the pathophysiological timeline of NEC and the involvement of Tregs is required for better understanding of this disease.

Reduced cutaneous inflammation associated with antioxidant action after topical application of the aqueous extract of Annona muricata leaves.

Annona muricata L. is used in folk medicine for treatment of diseases related to inflammatory and oxidative processes. This study investigated the effect of the aqueous extract of A. muricata leaves (AEAM) on TPA-induced ear inflammation and antioxidant capacity, both in vitro and in vivo. The in vitro antioxidant capacity of AEAM was measured by the 2,2-diphenyl-1-picrylhydrazyl (DPPH), ferric reducing/antioxidant power (FRAP) and lipoperoxidation assays. Cytotoxicity and reactive oxygen species (ROS) release were evaluated in the L929 fibroblasts. Swiss mice were submitted to TPA application and were topically treated with AEAM (0.3, 1 or 3 mg/ear). After 6 h, inflammatory and oxidative parameters were evaluated. Quercetin 3-glucoside, rutin, chlorogenic acid, catechin and gallic acid were identified in AEAM. It also presented antioxidant activity in all in vitro assays used. Incubation with AEAM did not cause cell cytotoxicity but reduced ROS release from fibroblasts. Compared with the control group, treatment with AEAM significantly reduced ear oedema and mieloperoxidase activity in inflamed ears, as well as histological parameters of inflammation. These results were associated with the reduction of total hydroperoxides and modulation of catalase, but not superoxide dismutase activity. These findings show the anti-inflammatory effect of AEAM is associated with antioxidant capacity.

Evidence for the involvement of IL-1ß and TNF-α in anti-inflammatory effect and antioxidative stress profile of the standardized dried extract from Miconia albicans Sw. (Triana) Leaves (Melastomataceae).

ETHNOPHARMACOLOGICAL RELEVANCE: Miconia albicans (Melastomataceae), commonly known in Brazil as "canela-de-velho", is used in folk medicine for treating rheumatoid arthritis and reducing pain and inflammation. THE AIM OF THE CURRENT WORK WAS: to provide data on physicochemical characterization of the drug plant and dried extract from M. albicans leaves, as well as investigate the anti-inflammatory effect and antioxidant stress profile from the standardized dried extract of this species employing different model systems. MATERIALS AND METHODS: plant material (dried crushed leaves) was extracted by turboextraction using 50% ethanol (v/v). Different pharmacological techniques were performed to establish quality control parameters of the plant drug, and dried extract of M. albicans (DEMA) was chemically characterized by HPLC-PDA to selection of the chemical marker. Total phenolic and flavonoid contents were determined by the Folin-Ciocalteu and AlCl3 colorimetric methods, respectively. Antioxidant potential of the DEMA was investigated by employing different in vitro antioxidant assays, including DPPH and ABTS radical scavenging assays, ferric reducing antioxidant assay, NO scavenging assay, metal ion (Fe2+) chelating activity and antioxidant capacity by inhibition of lipid peroxidation (TBARS). Finally, anti-inflammatory activity of the DEMA was evaluated using two models of acute inflammation: carrageenan induced inflammation and mechanical hyperalgesia. RESULTS AND DISCUSSION: M. albicans leaves, after drying in forced air circulation chamber at ±40 °C for 48 h and crushing in knife mill, presented a moisture content below the maximum allowed for plant drugs (6.4%). The powder of M. albicans was classified as moderately coarse and total ash content was found to be 6.27%. Preliminary phytochemical screening of DEMA revealed the presence of flavonoids, tannins, saponins, leucoanthocyanins and steroids. DEMA had significant higher total phenolic (551.3 mg gallic acid equivalent/g of dried extract) and flavonoid contents (367.19 mg catechin equivalent/g of dried extract). Two major compounds (λ = 340 nm) were identified in DEMA by HPLC-PDA: the flavonoids rutin and quercetin. Rutin content, selected as chemical marker, was determined and found to be 1.16 mg/g dried extract (r = 0.9941). Regarding to antioxidant activity, our results revealed the DEMA exhibited good antioxidant activity on different models. M. albicans treatment also reduced the levels of TNF-α e IL-1ß and consequently inflammatory nociception and edema caused by carrageenan injection. Based on previous studies and our results, is possible to suggest a positive correlation between the flavonoids rutin and quercetin and the antioxidant and anti-inflammatory capacities. CONCLUSION: Together, these data suggest that M. albicans has the possibility of use in conditions such as arthritis or other joint pain, even needing other work to better consolidate this profile.

Insight into the Exoproteome of the Tissue-Derived Trypomastigote form of Trypanosoma cruzi.

The protozoan parasite Trypanosoma cruzi causes Chagas disease, one of the major neglected infectious diseases. It has the potential to infect any nucleated mammalian cell. The secreted/excreted protein repertoire released by T. cruzi trypomastigotes is crucial in host-pathogen interactions. In this study, mammalian tissue culture-derived trypomastigotes (Y strain) were used to characterize the exoproteome of the infective bloodstream life form. Proteins released into the serum-free culture medium after 3 h of incubation were harvested and digested with trypsin. NanoLC-MS/MS analysis resulted in the identification of 540 proteins, the largest set of released proteins identified to date in Trypanosoma spp. Bioinformatic analysis predicted most identified proteins as secreted, predominantly by non-classical pathways, and involved in host-cell infection. Some proteins possess predicted GPI-anchor signals, these being mostly trans-sialidases, mucin associated surface proteins and surface glycoproteins. Moreover, we enriched phosphopeptides and glycopeptides from tryptic digests. The majority of identified glycoproteins are trans-sialidases and surface glycoproteins involved in host-parasite interaction. Conversely, most identified phosphoproteins have no Gene Ontology classification. The existence of various proteins related to similar functions in the exoproteome likely reflects this parasite's enhanced mechanisms for adhesion, invasion, and internalization of different host-cell types, and escape from immune defenses.

Long-term benefits of somatosensory training to improve balance of elderly with diabetes mellitus.

We evaluate the effects of somatosensory training on the mean amplitude of the center of pressure (COP) in the upright position and the sustained benefits after 6-month. Twelve elderly patients with type II diabetes (T2DM) participated in the study. Patients with T2DM were allocated to the somatosensory protocol, which consisted of a circuit composed of 13 stations with different textures. The rehabilitation protocol was applied twice a week during the period of 12 weeks. Upright balance, in 2 situations (fixed platform with eyes open and closed) to evaluate the mean amplitude of COP oscillation in the anterior-posterior and medial-lateral directions and the total area of COP oscillation. Outcomes were assessed at baseline, post-exercise and 6-month follow-up. The somatosensory training protocol was beneficial to reduce the AP oscillation of the COP, remaining after 6 months of the end of intervention in elderly with T2DM.

Ethnobotanical survey and antibacterial activity of some plants used in Guinean traditional medicine.

A total of 418 healers have been interviewed in Guinea, a coastal country of West Africa, ranging between 7 degrees 30 and 12 degrees 30 of northern latitude and 8 degrees and 15 degrees of western longitude. Plant species used by the local inhabitants to treat infectious diseases were identified using ethnobotanical, ethnographic and taxonomic methods. During these investigations, 218 plants were registered, of which the following were the most frequently used: Erythrina senegalensis, Bridelia ferruginea, Crossopteryx febrifuga, Ximenia americana, Annona senegalensis, Cochlospermum tinctorium, Cochlospermum planchonii, Lantana camara, Costus afer, Psidium guajava, Terminalia glaucescens, Uapaca somon and Swartzia madagascariensis. Most plants, and especially the leaves, were essentially used as a decoction. In order to assess antibacterial activity, 190 recipes were prepared and biologically tested, among which six showed activity (minimal inhibitory concentration<125 microg/ml) against Bacillus cereus, Mycobacterium fortuitum, Staphylococcus aureus, or Candida albicans, i.e., Entada africana, Chlorophora regia, Erythrina senegalensis, Harrisonia abyssinica, Uvaria tomentosa, and a mixture of six plants consisting of Swartzia madagascariensis, Isoberlinia doka, Annona senegalensis, Gardenia ternifolia, Terminalia glaucescens and Erythrina senegalensis.

Prolapso total do reto: analise de 30 casos / Total rectal prolapse: an analysis of 30 cases

Foram analisados retrospectivamente 30 pacientes (21 do sexo feminino e 9 do sexo masculino) portadores de Prolapso Total de Reto, tratados pelos Servicos de Proctologia do Hospital de Caridade (HC) e Hospital Universitario (HU), Florianopolis, SC, estudando-se a idade, doencas associadas e as tecnicas cirurgicas utilizadas para a correcao da procidencia. O estudo demonstrou que 23 (76,7//) pacientes tinham idade acima de 50 anos, havendo predominio de mulheres (70,0//-21 pacientes). A incidencia das afeccoes associadas foi de 73,3//(22 pacientes), sendo as mais frequentes a insuficiencia cardiaca congestiva, doenca pulmonar obstrutiva cronica e hipertensao arterial sistemica.As tecnicas cirurgicas utilizadas foram Cirugia de Thiersch (21 casos), Cirurgia de Carrapatoso (4 casos), Sacropromontofixacao (3 casos), Retossigmoidectomia perineal (1 caso) e Cirurgia de Thiersch associada a Cirurgia de Delorme (1 caso).Observou-se um maior numero de anestesias locais associadas as Cirurgias de Thiersch. Acirurgia foi realizada ambulatorialmente em 46,7//, sendo o tempo de permanencia hospitalar de 12,39 dias para os outros 53,3//dos casos. A recidiva foi de 10,0//e a conclusao e de que ha um lugar no tratamento desta afeccao para a operacao de Thiersch...