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Strictures in Crohn's disease (CD) are classically attributed to fibromuscular hypertrophy of the intestinal wall. We have identified and characterized CD-related ileal strictures that result instead from mural constriction (ie, reduced external circumference). Twenty-four strictures and internal controls from 17 adults with obstructive CD were analyzed by cross-sectional morphometry. The stricture-to-control circumference ratios (CRs) ranged from 0.53 to 1.7. Six strictures with CR ≥1.0, designated hypertrophic, had concentrically thickened walls, mean 3-fold increases in cross-sectional area and stainable fibromucular tissue, and high transmural inflammation scores. In contrast, 18 strictures with CR <1.0, designated constrictive, had thin, pliant walls, cross-sectional areas and stainable fibromuscular tissue comparable with control values, and low transmural inflammation scores. Eight mildly constrictive strictures also showed mild fibromuscular mural expansion that fell short of statistical significance. Twelve of 18 constrictive strictures (67%) occurred multiply (2–4 strictures per specimen) in contrast with hypertrophic strictures, all of which occurred singly (P =.01). Constriction correlated quantitatively with circumferential serosal fat wrapping (P =.003) and was associated with myenteric lymphocytic plexitis (P =.02). Disease duration was shortest among subjects with constrictive strictures and correlated with increasing circumference (CR ≤0.8, 6.3 ± 6.2 years; CR >0.8, 8.7 ± 6.4 years; and CR ≥1.00, 13.7 ± 5.0 years, respectively; P =.03). Constrictive ileal strictures in CD differ pathologically and clinically from hypertrophic strictures, featuring little or no fibromuscular mural expansion, frequent multiplicity, and earlier onset. Mesenteric fat wrapping and myenteric plexitis may contribute to their pathogenesis. Pathologic manifestations of constriction and hypertrophy can coexist, suggesting that stricture heterogeneity may be shaped in part by the dynamics of constrictive and hypertrophic processes. [Display omitted] [ABSTRACT FROM AUTHOR]

Heating/frying and reuse of edible fats/oils induces chemical changes such as formation of trans fatty acids (TFAs). The aim of this study was to investigate the effect of heating/frying on formation of TFAs in fats/oils. Using gas chromatography with flame ionisation detector, TFA was estimated in six commonly used fat/oils in India (refined soybean oil, groundnut oil, olive oil, rapeseed oil, clarified butter, partially hydrogenated vegetable oil), before and after subjecting them to heating/frying at 180 °C and 220 °C. All six fats/oils subjected to heating/frying demonstrated an increase in TFAs ( p < 0.001), saturated fatty acids ( p < 0.001) and decrease in cis -unsaturated fatty acids ( p < 0.001). The absolute increase in TFA content of edible oils (after subjecting to heating/reheating) ranged between 2.30 ± 0.89 g/100 g and 4.5 ± 1.43 g/100 g; amongst edible fats it ranged between 2.60 ± 0.38 g/100 g and 5.96 ± 1.94 g/100 g. There were no significant differences between the two treatment groups (heating and frying; p = 0.892). Considering the undesirable health effects of TFA, appropriate guidelines for heating/re-frying of edible fats/oils by Asian Indians should be devised. [ABSTRACT FROM AUTHOR]

A 66-year-old man presented with a chief complaint of difficulty breathing and productive cough. CT scan of the chest revealed an endobronchial mass with associated "tree-in-bud" opacities. A bronchoscopic biopsy of the mass was performed due to clinical suspicion of malignancy. Microscopic examination revealed inflamed endobronchial mucosa, granulation tissue and abundant fragments of uncharacterized organic material, compatible with aspiration. Detailed history revealed a history of chewing "gutkha", a form of smokeless tobacco comprising a mixture of betel nut and other condiments. Microscopic sections of a betel nut and the "gutkha mix" processed subsequently in the histology laboratory were found to be similar to the organic material found in the mass. Thus, a diagnosis of impacted betel nut mixture leading to post-obstructive pneumonia was rendered. [ABSTRACT FROM AUTHOR]

Abstract: Trans fatty acids (TFA) are unsaturated fatty acids that contain at least one non-conjugated double bond in the trans configuration, resulting in a straighter shape. TFA present in our diet can either be industrially produced and ruminant or natural. The major process contributing to formation of industrial TFA is hydrogenation of vegetable oils. Thermal processes such as edible oil refining and frying also lead to the formation of TFA while, ruminant/natural TFA is formed in the rumen of ruminant animals through bio-hydrogenation. Industrial TFA poses severe effects on our health like cardiovascular problems, insulin resistance, infertility in women, compromised fetal development and cognitive decline. There are strict regulations for limiting/removing the TFA content from food supply across the world. However in India, there is scarcity of data on TFA content in foods and their consumption levels. Given the alarmingly rising trend of diabetes and cardiovascular disease in India, removal of TFA from the food supply along with generating awareness among the masses in this regard is of immense importance. [Copyright &y& Elsevier]

Industrially produced trans fat (iTFA) is a harmful compound created as a substitute for animal and saturated fats. Estimated to cause up to 500,000 deaths per year, it is replaceable. In 2018, Resolve to Save Lives, the World Health Organization (WHO), Global Health Advocacy Incubator, and NCD Alliance partnered to achieve global trans fat elimination. The WHO Director-General called for the elimination of trans fat by 2023 through best practice policies outlined in the WHO REPLACE package. Since the accelerated global efforts in 2018, 43 countries have adopted best practice regulations protecting an additional 3.2 billion people and building momentum toward global elimination. Current coverage will prevent 66% of deaths estimated to be caused each year by trans fat in foods. Despite producing and selling iTFA-free products in many countries, companies continue to sell iTFA-containing products in unregulated markets. Global incentives, accountability mechanisms, and regional policies will help achieve the elimination goal. • Policies can reduce known risk of coronary heart disease due to trans fat consumption. • A strategic partnership accelerated progress toward global elimination of trans fats by 2023. • Policies in place today will prevent 66% of the deaths estimated to be caused by trans fats each year. • Global trans fat elimination offers a model to tackle other nutrition policy priorities. [ABSTRACT FROM AUTHOR]

Aim: To investigate the associations of high body fat and low muscle mass with arterial stiffness in Asian Indians with type 2 diabetes mellitus (T2DM) in North India. Methods: In this cross sectional study, subjects with T2DM (males n = 110, females n = 58, mean age: 53.8 ± 10.0 years) were recruited. Anthropometry and body composition analysis were performed and measures of glycemia, lipids and PWV were analyzed. Results: Significant positive correlation was observed between PWV and body fat (p < 0.05), left leg fat (p < 0.05), and right leg fat (p < 0.01) percentages only in females. In males, significant negative correlation was observed between PWV and truncal fat free mass (p < 0.05) and fat free mass in right arm (p = 0.05) and left arm (p < 0.05). In both males and females, significant negative correlation was observed between PWV and fat free mass in left leg (p < 0.01) and for right leg fat free mass only in females. Conclusion: Excess adiposity and low fat free mass are associated with arterial stiffening in Asian Indians with T2DM in North India, with significant gender differences. [ABSTRACT FROM AUTHOR]