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Objective: Psoriatic Disease (psoriasis - psoriatic arthritis) is an inflammatory systemic condition associated to obesity.Weight loss improves clinical severity. Mediterranean Diet (MD) has been considered a model of healthy and a very low-calorie ketogenic diet (VLCKD) is more effective for losing weight fast in obese. The study aims to determine the effectiveness of the MD and the VLCKD in the treatment of patients with inflammatory disease. Patients and Methods: Twenty patients were identified as overweight and obese from 1st to 3rd degree using Body Mass Index (BMI). MD has been proposed to overweight patients while obese patients could choose between MD and VLCKD, according to their attitudes. Then, they were divided into two study groups (MD group and KD group). Results: At baseline and after four weeks, we collected weight, BMI, waist circumference (WC) and body composition through bioimpedance analysis (BIA - Bioelectrical Impedance Analysis). At the end, both of dietary interventions were effective to improve all parameters, but we found a greater and significative reduction of BMI and WC, and more reduction of fat mass (FM) in KD group than MD group. Conclusions: Preliminary data show that KD could be proposed as a first dietary intervention to obtain a rapid weight loss and maintenance of lean mass.

Noroviruses are a leading cause of epidemic and pandemic acute gastroenteritis (AGE) worldwide, and contaminated food and water are important routes for its transmission. Raw sewage has been used for viral surveillance to monitor the emergence of new norovirus strains with the potential to cause epidemics. In this study, we investigated norovirus occurrence and norovirus RNA levels in 156 samples collected from May 2013 to May 2014, across three different stages (52 samples each) of a wastewater treatment plant (WWTP) in Rio de Janeiro, Brazil. We also explored norovirus GII diversity in raw sewage samples by next-sequencing generation (NGS). In addition, we examined norovirus prevalence and molecular epidemiology from acute gastroenteritis cases. Using RT-qPCR, norovirus GI and GII was detected in 38.5% and 96.1% of raw sewage samples, 40.4% and 96.1% of primary effluent samples and 1.9% and 5.8% of final effluent samples, respectively. Norovirus RNA levels varied from 4 to 6.2 log10 genome copies per litre (gc L−1) for GI and from 4.4 to 7.3 log10 gc L−1 for GII. Using MiSeq NGS, we identified 13 norovirus genotypes over the one-year period, with six dominant capsid genotypes, including GII.4, GII.17, GII.5, GII.2, GII.3 and GII.1. GII.4 noroviruses were the most prevalent in wastewater samples (68.5%), and a similar trend was observed in AGE cases (71%). The emergent GII.17 was the second most prevalent genotype (14.3%) identified in the raw sewage samples, however, it was not detected in clinical cases. Due to the high burden of norovirus outbreaks and the lack of vaccine and antiviral drugs, it is essential to understand the genotypic diversity of norovirus at the population level. Complementary data obtained from both clinical and environmental (sewage) samples proved to be an effective strategy to monitor the circulation and emergence of norovirus epidemic genotypes. Keywords: Noroviruses, Wastewater, Environmental surveillance, Next-generation sequencing, Phylogenetic analysis

Background and aims: Percutaneous coronary intervention (PCI) is the most frequently used revascularization approach, often repeatedly applied. The quest for the ultimate revascularization procedure however may capture cardiologist’s attention and lead them to minimize the issue of secondary prevention in their patients. Aims of this study were to assess: 1. The individual risk factor profile, 2. The relation between the risk factors correction and the number of hospital admissions for elective procedures, 3. The appropriateness of medical treatment in patients admitted for elective coronary invasive procedures (diagnostic and interventional). 4. The patients knowledge of threshold values for cardiovascular risk factors. Patients and Methods: 100 patients (71% males, mean age 68 years) consecutively admitted for elective coronary angiography or PCI. They underwent a classical risk factors assessment and were divided in three groups according to the number of admissions for coronary angiography and in two groups according to the number of PCIs. Results: Fifty-seven % of patients had been previously admitted for invasive examination at least three times and 58% had already been treated with at least one PCI. Seventyone % were treated with beta-blockers but only 25% of them received a dosage found effective in RCTs (randomized clinical trials). Sixty % were treated with ACE-inhibitors and 83% received the dosage found effective in RCTs. Fifty-two % were treated with statins and 95% received a dosage found effective in RCTs. Nine % were still active smokers. Fourtynine % had a LDL cholesterol level above 100 mg/dL. The percentage of patients not on target was unrelated to the number of hospital admissions for invasive procedures. Conclusions: Modern cardiology is quickly embracing high tech procedures and trials results but often fails to spend enough time teaching how to control risk factors according to the recommendations of the evidence-based guidelines, even independently of the number of hospitalizations for invasive cardiovascular procedures.