Inflammation, oxidative stress, and vitamin D play pivotal roles in the pathogenesis and progression of both type 2 diabetes (T2D) and depression through several interconnected biochemical mechanisms. In T2D, chronic inflammation is driven by an excess of pro-inflammatory cytokines like TNF-α, which impairs insulin signaling by activating serine kinases that phosphorylate insulin receptor substrate-1. Oxidative stress further exacerbates this condition by generating reactive oxygen species (ROS), which damage cellular proteins, lipids, and DNA, thereby promoting β-cell apoptosis and worsening insulin resistance.

In depression, neuroinflammation and oxidative stress disrupt neurotransmitter homeostasis, particularly serotonin, by increasing the production of inflammatory cytokines which activate the enzyme indoleamine 2,3-dioxygenase (IDO), diverting tryptophan metabolism from serotonin production towards kynurenine pathway metabolites that are neurotoxic, contributing to depressive symptoms. Vitamin D modulates these pathways by exerting anti-inflammatory and antioxidant effects.

Polyunsaturated fatty acids (PUFAs), particularly omega-3s, ameliorate these conditions by penetrating cell membranes, where they reduce the production of pro-inflammatory eicosanoids from arachidonic acid and enhance mitochondrial function, reducing oxidative stress by improving electron transport chain efficiency and decreasing ROS production. Consequently, PUFA supplementation may restore insulin sensitivity in T2D and reduce neuroinflammation in depression, offering a targeted approach to managing these complex conditions.

This study investigates the biochemical changes that occurred over a 6-month period induced by omega-3 polyunsaturated fatty acid supplementation. We examined oxidative stress and inflammation biomarkers, alongside 25 OH vitamin D levels, in several patient groups: depressive, diabetic, and patients with both conditions. The findings were further analyzed in relation to cortisol and serotonin levels to elucidate the impact of omega-3 PUFAs on molecular homeostasis. The interesting beneficial effects observed can be attributed to the PUFAs' ability to stabilize and structurally integrate into cell membranes, thereby normalizing fluidity and enhancing the cellular resilience against oxidative stress and inflammation.

Introduction

Heart rate variability (HRV) reflects the balance between the arms of the autonomic nervous system (ANS). ANS control is strongly associated with body composition in healthy young populations and athletes, suggesting that obesity negatively impacts the ANS. The occupational demands and work environment of firefighters promote high rates of obesity. ANS control is particularly important for firefighters, who have an unpredictable work schedule and must quickly switch between restful and active states. Given the importance of ANS function in firefighters and the potential impedance of obesity, studies on the association between HRV and body composition in firefighters are needed.

METHODS

Sixteen full-time male firefighters participated in this cross-sectional study. Resting HRV (RR interval) was measured for 10 minutes with an actigraphy watch and chest heart rate monitor. An analysis of the collected data (Kubios HVR) was completed to determine the following HRV outcomes: RR interval, RMSSD, percentage of low-frequency power (LF), percentage of high-frequency power (HF), LF/HF ratio, parasympathetic nervous system index, and sympathetic nervous system index. Measures of body composition (InBody 580), height, and weight were taken. Partial correlation coefficient analyses were performed between (a) body mass index (BMI) and (b) body fat percentage, and each of the HRV outcome variables, after adjusting for age. SPSS version 29 was used for the statistical analysis (α=0.05).

RESULTS

No significant association was found between RMSSD and either BMI (p=0.54, r=0.17) or body fat percentage (p=0.64, r=0.13). All other correlation coefficients were similarly non-significant (p>0.05) and weak (-0.30<r<0.30).

CONCLUSION

There was no association between body composition variables and HRV outcomes in this small sample of firefighters, in contrast to similar research showing a relationship between HRV measures and fat-free mass in trained athletes. A larger sample is needed to make more generalizable conclusions. Analysis of previously collected data will continue in the future.

Metformin, a first-line anti-diabetic medication, is used in the management of type 2 diabetes worldwide. Defects in insulin secretion, insulin activity, or both in diabetic patients affect the metabolism of carbohydrates, fat, and protein (which causes high blood glucose levels and obesity). Metformin decreases glucose production, increases insulin sensitivity, and enhances peripheral glucose uptake. Its effectiveness in managing blood glucose levels is well documented; however, the association between Metformin treatment and blood glucose levels and body weight remains a subject of investigation. This study aims to assess the association between the dosage and duration of metformin treatment with fasting blood glucose (FBS) level and body mass index (BMI) of diabetic patients. A cross-sectional study was conducted with 162 type 2 diabetic patients on routine checkup at Cape Coast Teaching Hospital in Ghana. Information on FBS level and BMI, metformin treatment, and demographic characteristics were obtained from records and face-to-face-interviews using a structured questionnaire. Pearson’s correlation was used to analyze the association between dosage and duration of metformin treatment with FBS level and BMI. The dosage of metformin treatment showed a significant positive correlation with the FBS level (r = 0.165, p = 0.036*) and the duration of metformin treatment showed a highly significant negative correlation with the FBS level (r = -0.204, p = 0.01**). However, there was no significant correlation between the dosage of metformin treatment and BMI (r = 0.109, p = 0.168) and between the duration of metformin treatment and BMI (r = 0.0790, p = 0.319). These results indicate that the dosage and duration of metformin treatment significantly affects fasting blood glucose level. Monitoring metformin treatment based on fasting glucose levels is more effective for managing diabetes than using body mass index as a guide.

Background: Obstructive sleep apnoea (OSA) is a chronic disorder characterised by the periodic cessation or shallowing of breathing during sleep due to the collapse of the soft tissues of the throat. It is associated with episodes of reduced blood oxygen saturation and periods of micro-awakenings. The prevalence of OSA is increasing in obese individuals, men, and the elderly.

Methods. A retrospective study was conducted between 2022 and 2023, analysing data from 57 patients with hypertension and coexisting obstructive sleep apnea. The patients were divided into two groups: a study group with moderate/severe sleep apnoea (n=26) and a control group without apnoea/mild sleep apnoea (n=31). The demographic data, respiratory parameters obtained from a sleep polygraph, and information on comorbidities were analysed. The aim of this study was to compare the groups in terms of respiratory parameters and comorbidities.

Results: The group with moderate/severe sleep apnoea exhibited significantly elevated desaturation values (mean 4.97 vs 3.84; p < 0.001), a longer duration of a single apnoeic episode (mean 19.85 vs. 16.50 seconds: p=0.002), and a higher percentage of snoring (28.25 vs 12.00; p<0.001) compared to the second group. The presence of any chronic disease in patients with hypertension and OSA (e.g. hyperlipidaemia, type 2 diabetes mellitus, atherosclerosis, stable coronary artery disease, atrial fibrillation, renal disease, heart failure with preserved and reduced ejection fraction, and the presence of aortic aneurysm) was found to increase the severity of the apnoea--hypopnoea index (AHI) fourfold.

Conclusions: Patients with hypertension and moderate/severe sleep apnoea exhibit diminished respiratory performance during sleep. A correlation was identified between the severity of the AHI and the presence of the aforementioned chronic diseases in this group of patients, which may result in significant complications and necessitate more aggressive treatment.

Introduction: Compared to the general population, kidney transplant recipients have a significantly higher risk of contracting cardiovascular disease, which is one of the leading causes of death in these patients. The aim of this analysis is to compare some novel myocardial damage biomarkers with standard ones and with cardiac ultrasonography measurements in this group of patients.

Methods: The study included 91 adult kidney transplant recipients whose data on cardiac ultrasound was compared with levels of the following cardiac damage biomarkers: galectin-3, soluble interleukin 1 receptor-like 1 (ST2), FK506-binding protein-like, procollagen type III N-terminal peptide, and periostin. Patients were divided into two groups based on diastolic dysfunction grade.

Results: The median age of patients was 43 years (interquartile range—IQR: 37-53). Galectin-3 showed a significant positive correlation with the systolic-to-diastolic velocity ratio (r=0.300, p≤0.05), while a negative correlation was found with the left atrium volume index (r=-0.377, p≤0.05). ST2 showed a significant positive correlation with the left ventricular mass index (r=0.318, p≤0.05) and procollagen type III N-terminal peptide with peak velocity blood flow in late diastole caused by atrial contraction (r=0.289, p≤0.05). Serum periostin showed a significant positive correlation with the systolic-to-diastolic velocity ratio (r=0.329, p≤0.05), while a negative correlation was found with the peak velocity blood flow from left ventricular relaxation in early diastole (r=-0.343, p≤0.05). A between-group comparison in terms of diastolic dysfunction grade showed that patients withdiastolic dysfunction grades 0 and 1 had significantly higher levels of galectin-3 compared to the patients with grade 2 and 3 (17.53 vs. 15.92 ng/ml, p=0.03).

Conclusion: Analyzed biomarkers show significant potential in determining the level of cardiac function commonly measured by ultrasonographic methods. Given their correlation with some standard biomarkers and diastolic dysfunction grade observed in this analysis, these biomarkers could be utilizedin procedures by evaluating cardiac function in kidney transplant recipients and contributing to timely diagnosis of these conditions.

Background: Psoriasis is recognized as a systemic inflammatory disease that is characterized by metabolic syndrome. The MTHFR C677T gene is significant in psoriasis. Objectives: We are seeking to determine the prevalence of the MTHFR C677T genotype among plaque psoriasis patients and its correlation with clinical and subclinical characteristics at Can Tho Dermatology Hospital. Materials and Methods: From 2021 to 2023, 50 patients with plaque psoriasis who were treated at Can Tho Hospital of Dermato-Venereology participated in a descriptive cross-sectional study. Results: The percentage of males was 55.7%. The mean age was 46.60±14.77 years. The <40 years old group constituted 67.1% of the total. Disease had an average duration of 12.96±10.69 years. The symptom of stinging was prevalent (85.7%). Trunk (77.1%), cranium and extremities (75.7%), and nails (62.9%) were the most common sites of injury. The prevalence of metabolic syndrome was 47.1%. Plaque psoriasis patients with the MTHFR C677T C/T phenotype accounted for 48% and there were no cases with the T/T phenotype. When comparing patients with plaque psoriasis with the MTHFR C677T C/T phenotype with the group of the C/C phenotype, people carrying the T allele had a longer disease duration (13.83±10.45 and 8.27 ±5.71 years), more fold injuries (37.5% and 11.5%), a higher fasting blood glucose concentration (5.92±1.16 and 8.15±4.13), and a higher rate of metabolic syndrome (72.7% and 31.8%). Conclusions: MTHFR C677T C/T genotype plaque psoriasis patients had a longer illness duration, more lesions in the folds, and a greater risk of hyperglycemia and metabolic syndrome than C/C genotype carriers.

Introduction:

Atrial Fibrillation (AF) is an abnormal, rapid, and irregular cardiac arrhythmia.¹ AF is associated with a five-fold increase in stroke risk, but anticoagulation given to eligible patients can reduce this risk by 65%.² Dental practices are increasingly seen as an appropriate healthcare environment in which to undertake healthcare prevention.

This qualitative study aimed to explore perceptions of and barriers faced by dental staff in screening for Atrial Fibrillation using a hand-held electronic device in a primary dental care setting.

Methods:

Purposive sampling was used to recruit participants from a large mixed NHS (National Health Service) and private dental practice. Interviews were semi-structured, face-to-face, audio-recorded, and transcribed verbatim amongst dental professionals within the practice. Interviews continued until no new themes or patterns emerged from the data and thematic saturation had been achieved.

Results:

Eleven participants were interviewed. Overall, the responses were positive. Four out of seven clinicians expressed concerns about time and remuneration. They felt screening would be well received but could heighten anxiety among patients. Seven out of eleven participants stressed their preference to refer the patients to their GP (General Practitioner) for confirmation after the initial screening. Encouraging feedback regarding the simplicity of the portable screening device was given. Participants also proposed models of screening, such as using private screening booths.

Conclusions:

Overall, the AF screening was deemed to be a good concept amongst participants, but concerns were expressed about time, remuneration, and heightening anxiety among patients. A need for further research is indicated whilst evaluating the role of dental care professionals.

Introduction: Substance Use Disorders (SUD) and Major Depression Disorders (MDD) are both causes of disability around the world, and the prevalence of their comorbidity is very high and complicates the clinical management of patients. The alteration of the circadian rhythmic system has been proposed as a factor related to the onset, severity, and course of both disorders, although the exact influence is not yet well defined and less in dual condition.

Methods: Three major databases (Web of Science, Scopus, and PubMed) were selected to search for articles that comprise information about SUD, MDD, and circadian rhythmicity in the last 10 years (2013-2024). Parameters were identical in all databases [("addiction" OR "substance use" OR "dual disorder") AND depression AND ("circadian" OR "sleep-wake")]. Results without one of these parameters; with animal models; or in languages other than English, Spanish, Portuguese or French were excluded.

Results: A total of 613 articles were found. After exclusion of the duplicates, a total of 436 articles were left. From those, more than 20% of those did not have an SUD condition and about a third of the MDD results were mixed with bipolar disorders (BDs). With the application of the inclusion and exclusion criteria, a total of 245 articles were selected.

Conclusion: This work will present the main findings of circadian rhythmicity, including data of the sleep--wake rhythm, with an emphasis on improving our understanding of the multifactorial explanatory model of SUD, MDD, and their comorbidities. It is important to steer future studies aiming at the clarification of the onset and possible treatment outcomes of these disorders. This could lead to more assertive and efficient prevention and treatment programs for both disorders from a more individualized approach.

Introduction

Hospital disinfection is crucial for infection prevention, especially with rising bacterial resistance. Effective disinfectants compliant with European biocide regulations (528/2012 CE) are needed. At Clínica Universidad de Navarra, we started using Hypochlorous acid (Klorxitol®) in March 2022. We conducted a study to verify its efficacy by taking surface cultures before and after its application.

Methods

Hypochlorous acid (Klorxitol®) was applied via nebulization in wards and misting in operating theatres. We cultured five surfaces before and after disinfection on nine occasions. Nebulization used the BYOPLANET® Electrostatic Sprayer System, which requires no PPE or ventilation sealing. The high-touch surfaces sampled included patient armchairs, toilet flushes, nurse call bells, bed trays, and bed controls. In operating rooms, a mist system sprayed Klorxitol® for 15 seconds, followed by a 5-minute settling time. The sampled surfaces included the surgical table, keyboards, instrument tables, and door elbow push pads. Statistical analysis was conducted using IBM SPSS, calculating the absolute reduction in Colony-Forming Units (CFU) pre- and post-disinfection. Paired Student's t-tests and confidence interval calculations were used, with results presented in BoxPlot diagrams.

Results

Both application methods demonstrated significant efficacy. The BYOPLANET® Electrostatic Sprayer System showed a significant reduction in CFU (P < 0.001). Specific surfaces with significant reductions included the bed rail (p = 0.002) and table edge (p = 0.019), though the cistern handle was not significant (p = 0.171). The mist system also showed a significant CFU reduction. The mean CFU count decreased from 20.17 (95% CI -2.05 – 62.39) with a SD of 30.7 before disinfection to 8.33 (95% CI -11.59 – 28.25) with a SD of 18.98 after disinfection (p = 0.031).

Conclusion

Hypochlorous acid (Klorxitol®) effectively reduces bacterial contamination on hospital surfaces, meeting disinfection standards and supporting its use as a reliable disinfectant in healthcare settings.

In this study, we tried to assess whether the existing diagnostic criteria for chronic kidney disease are insufficient for practice and whether new early laboratory markers of chronic kidney disease exist. Chronic kidney disease (CKD) is an umbrella term that indicates damaged kidney tissue, regardless of etiological origin. Based on several large studies, experts have come to the decision that albuminuria is a high risk factor for death in cardiac and renal diseases, diabetes, and arterial hypertension. The participants in this study were divided into three groups based on the main etiological causes of chronic kidney disease: the first group comprised those with hypertension, the second group comprised those with type 2 diabetes mellitus, and the third group comprised those with comorbid conditions of these diseases. They were subjected to standard and special laboratory analyses, and the results of the analyses were compared. In the patients, nephrinuria and aldosterone in the blood were determined, indicating kidney podocyte dysfunction, as well as collagen IV, indicating tubulointerstitial dysfunction, and these were compared with the standard diagnostic indicator albuminuria, and inter-group differences were assessed. It can be concluded that in all three groups, microalbuminuria did not serve as a predictor of chronic kidney disease, but it has now been replaced by more reliable urine nephrinuria and collagen IV analyses.