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Diabetes and skin cancers have emerged as threats to public health worldwide. However, their association has been less intensively studied. In this narrative review, we explore the common risk factors, molecular mechanisms, and prognosis of the association between cutaneous malignancies and diabetes. Hyperglycemia, oxidative stress, low-grade chronic inflammation, genetic, lifestyle, and environmental factors partially explain the crosstalk between skin cancers and this metabolic disorder. In addition, diabetes and its related complications may interfere with the appropriate management of cutaneous malignancies. Antidiabetic medication seems to exert an antineoplastic effect, however, future large, observation studies with a prospective design are needed to clarify its impact on the risk of malignancy in diabetes. Screening for diabetes in skin cancers, as well as close follow-up for the development of cutaneous malignancies in subjects suffering from diabetes, is warranted.

On 7th May 2022, human monkeypox was identified in the United Kingdom, a non-endemic zone, with subsequent multi-country outbreaks. About 6 weeks later, the European Centre for Disease Prevention and Control reported 1158 confirmed cases in non-endemic countries scattered within the European Economic Area (EEA), and a total of 1882 cases confirmed worldwide, inclusive of the EEA. These numbers are expected to increase with high alert and amplified surveillance established in non-endemic regions. In light of a looming epidemic, current understanding of the virus, and identification of gaps in the literature remain critical hence warranting a scoping review of available literature.Literature searches were performed through PubMed, SCOPUS, ScienceDirect and Hinari to identify studies eligible for inclusion in accordance with PRISMA guidelines.Seventy-seven articles were included in the review. Majority of the cases were from the Central African clade (n = 29,905) versus the West African clade (n = 252). 6/16 articles that reported vaccination status stated that none of the cases were vaccinated. In the remaining articles, approximately 80%-96% cases were unvaccinated. It was noted that 4%-21% of the vaccinated individuals got infected. The secondary attack rate ranged from 0% to 10.2%, while the calculated pooled estimated case fatality rate was 8.7%.This scoping review provides an extensive look at our current understanding on monkeypox disease. Further studies are needed to better understand its risk factors, genetics and natural history, in order for public health strategists to generate prevention strategies and management decisions.

Background: The development of digital technologies and the evolution of open innovation approaches have enabled the creation of diverse virtual organizations and enterprises coordinating their activities primarily online. The open innovation platform titled "International Natural Product Sciences Taskforce" (INPST) was established in 2018, to bring together in collaborative environment individuals and organizations interested in natural product scientific research, and to empower their interactions by using digital communication tools. Methods: In this work, we present a general overview of INPST activities and showcase the specific use of Twitter as a powerful networking tool that was used to host a one-week "2021 INPST Twitter Networking Event" (spanning from 31st May 2021 to 6th June 2021) based on the application of the Twitter hashtag #INPST. Results and conclusion: The use of this hashtag during the networking event period was analyzed with Symplur Signals (https://www.symplur.com/), revealing a total of 6,036 tweets, shared by 686 users, which generated a total of 65,004,773 impressions (views of the respective tweets). This networking event's achieved high visibility and participation rate showcases a convincing example of how this social media platform can be used as a highly effective tool to host virtual Twitter-based international biomedical research events.

The International Journal of Medical Students (IJMS) has emerged over the past decade as a critical platform for showcasing medical student innovation and experiences. Though the work of trainees has historically been undervalued and over scrutinized, the IJMS is committed to highlighting the immense capacity for novel and robust research in this cohort. Thus, supporting an upcoming generation of leaders in medicine and academia to gain confidence in their work and contribute positively to the scientific community. In this issue of the IJMS, we are proud to present 16 articles from the Americas, Europe, Asia, and Africa. Original research articles cover a breadth of topics, including medical training, impacts of the COVID-19 pandemic on teaching and communication, pediatric respiratory illness, gender equity in medicine, understudied illnesses, and cardiovascular disease. The IJMS is proud to feature first-hand experiences of medical trainees in each issue. Accordingly, in the present issue perspectives of six medical students are outlined following unique and career-altering experiences. From working in palliative care to international outreach program, local vaccination initiatives, and the creation of a student-oriented research and innovation council in India. The IJMs extends our gratitude to our contributors, team, and readers for another remarkable issue.

Diabetes is a complex metabolic disease that has been associated with epigenetic changes. External factors such as dietary patterns can induce an imbalance in the pools of micronutrients and macronutrients in the body. Consequently, bioactive vitamins may influence epigenetic mechanisms via several pathways: involvement in the control of gene expression, and in protein synthesis, by acting as coenzymes and co-factors in the metabolism of methyl groups or methylation of DNA and histones. Herein, we present a perspective on the relevance of bioactive vitamins in the epigenetic modifications that occur in diabetes.

Guar gum can be used as an adjuvant in the treatment of dyslipidemia. However, based on data from different studies, the effectiveness of this product is not uniform. Therefore, we conducted a dose-response meta-analysis between guar gum supplementation and lipid profile.Five databases (Scopus, Web of Science, PubMed/Medline, Embase, and Google Scholar) were searched to identify relevant articles published up to July 2020. The weighted mean difference (WMD) was derived based on the random-effects model. Overall findings were generated from 25 eligible trials. Patients' conditions included hyperlipidemia, diabetes, metabolic syndrome, hypertension, overweight, carotid endarterectomy, and menopausal women. Prescribed gum dose varied between 100 mg/d and 30 g/d for 1-24 months. Compared with control groups, guar gum supplementation decreased total cholesterol (TC) by -20.41 mg/dL (95% CI: -26.76 to -14.07; P 0.001) and low-density lipoprotein-cholesterol (LDL-C) by -17.37 mg/dL (95% CI: -23.60 to -11.13; P 0.001), but did not change triglycerides (TG) (WMD: -6.53 mg/dL, 95% CI: -16.03 to 2.97; P = 0.178) and high-density lipoprotein-cholesterol (HDL-C) (WMD: -0.62 mg/dL, 95% CI: -1.68 to 0.44, P = 0.252).Guar gum supplementation significantly reduced serum LDL-C and TC levels in patients with cardiometabolic problems, but had neutral effects on TG and HDL-C levels.

The identification of paediatric obesity predictors in the early stages of life is warranted, as it can influence the development of effective strategies to prevent metabolic disorders. In this case–control study, we assessed nine risk factors for paediatric obesity, namely a birth weight > 4000 g, an exclusive breast-feeding period < 4 months, the introduction of solid food at < 4 months, maternal overweight or obesity before pregnancy, maternal smoking during pregnancy, the presence of gestational diabetes, paternal overweight and obesity and paternal smoking. In order to identify the most relevant predictors of paediatric obesity, we employed a multiple logistic regression model with R2 Cox Snell by adjusting confounders. In the randomly selected 509 preschool children from Tehran, children exposed to gestational diabetes had the maximum predicted probability of obesity (4·36 (1·94, 9·80) %) among the analysed risk factors %. The introduction of solid food at < 4 months of age increased the risk of obesity by 2·98 (1·77, 4·97 %). The OR of childhood obesity was associated with maternal overweight and obesity (2·72(1·60–4·60) %), maternal smoking (2·21 (1·18, 4·11) %) and excessive gestational weight gain (1·89 (1·23, 2·91) %). Paternal smoking and high birth weight increased the risk of paediatrics obesity > 1·8 times (1·15–2·94) and > 1·5 times (1·015–2·43), respectively. There was no association between the paternal BMI, the exclusive breast-feeding time and the risk of paediatric obesity. Among early risk factors, probably gestational diabetes can be considered as the most important predictor for the risk of paediatric obesity.

Several randomized clinical trials have investigated the effect of dietary advanced glycation end products (AGEs) on metabolic syndrome risk factors in adults. However, the results of these studies were conflicting. Therefore, our aim was to assess the effect of dietary AGEs on metabolic syndrome risk factors. We searched the PubMed-MEDLINE, Scopus, Cochrane Databases, Google Scholar, Web of Science, and Embase databases for papers published up to October 2019 that investigated the effect of dietary AGEs on metabolic syndrome risk factors. From the eligible trials, 13 articles were selected for inclusion in this systematic review and meta-analysis. The meta-analysis was performed using a random-effects model. Heterogeneity was determined by I(2) statistics and Cochrane Q test. Pooled results from the random-effects model showed a significant reduction for insulin resistance [weighted mean difference (WMD): −1.204; 95% CI: −2.057, −0.358; P = 0.006], fasting insulin (WMD: −5.472 μU/mL; 95% CI: −9.718, −1.234 μU/mL; P = 0.011), total cholesterol (WMD: −5.486 mg/dL; 95% CI: −10.222, −0.747 mg/dL; P = 0.023), and LDL (WMD: −6.263 mg/dL; 95% CI: −11.659, −0.866 mg/dL; P = 0.023) in the low-AGEs groups compared with the high-AGEs groups. There were no changes in the other components of the metabolic syndrome. The results of this review suggest that a diet with a low AGEs content has beneficial effects on insulin resistance, fasting insulin, total cholesterol, and LDL. Moreover, following a diet low in AGEs may be a helpful strategy to decrease the burden of metabolic syndrome risk factors in adults and particularly in patients with diabetes.

To assess serum vitamin D trend from baseline to 12 months after one anastomosis gastric bypass (OAGB).In this observational cohort analysis of longitudinal data, we assessed the trend of serum vitamin D, and its associations with anthropometric, and biochemical measurements in 98 patients undergoing OAGB in a bariatric surgery center. All participants were on800 IU/day vitamin D supplementation.Vitamin D, lipid profile, creatinine, and albumin levels significantly improved at 12 months post-surgery. Vitamin D concentrations significantly increased from 26.52 ± 12.32 to 54.52 ± 27.90 ng/mL at 12 months. The correlations between vitamin D concentrations and weight, body mass index, lipid profile, ferritin, glycemic indices, and albumin were not significant. In addition, the correlations between vitamin D and parathormone, vitamin D receptor, calcium, phosphorus, body composition, and basal metabolic rate (BMR) did not reach the threshold of statistical significance at 12 months following bariatric surgery. Although there was a significant correlation between body weight and body composition (P 0.001) and basal metabolic rate (BMR) (r = 0.762, P 0.001) at 12 months, there were no significant correlations between weight change percent and body composition (P 0.05), BMR (r = -0.101, P = 0.350), and vitamin D (r = 0.120, P = 0.271) at 12 months.Our results showed that supplementation of vitamin D with dosage of800 IU/day is sufficient for prevention of vitamin D deficiency within 12 months after OAGB surgery. Note: This data is mandatory.

Hepatic disease accounts for approximately 2 million deaths/year worldwide. Liver fibrosis, as the last stage of numerous chronic liver diseases, is one of the most relevant prognostic factors. The liver biopsy with the histopathological examination is considered to be the "gold standard" for the identification and staging of the hepatic fibrosis. However, liver biopsy is known as an invasive investigation that has multiple limitations. Research studies conducted in the last few years focused on identifying non-invasive type methods for the evaluation of hepatic fibrosis; usually, there are 2 categories of such investigations: serologic tests and imaging techniques. This narrative review presents the non-invasive investigation methods used in the liver fibrosis evaluation. New molecular perspectives on fibrogenesis and fibrosis regression, as well as the appearance of therapeutic antifibrotic agents, justify the necessity of non-invasive tools to detect and grade liver fibrosis.

Inconsistencies exist with regard to the influence of omega-3 supplementation on 25-hydroxyvitamin D (25(OH)D) levels, which could be attributed to many factors, such as the duration and dose of omega-3 supplementation, and individuals' baseline 25(OH)D levels. Therefore, to address the inconsistencies, we conducted a systematic review and dose-response meta-analysis to accurately determine the effect of omega-3 supplementation on 25(OH)D levels in humans.We performed a comprehensive literature search in Web of Science, PubMed/Medline, Scopus, and Embase databases from inception up to January 2020. We included only randomized controlled trials (RCTs). We used weighted mean difference (WMD) with 95% confidence interval (CI) to assess the influence of omega-3 supplementation on serum 25(OH)D levels using the random-effects model.Our pooled results of 10 RCTs demonstrated an overall significant increase in 25(OH)D levels following omega-3 intake (WMD = 3.77 ng/ml, 95% CI: 1.29, 6.25). In addition, 25(OH)D levels were significantly increased when the intervention duration lasted8 weeks and when the baseline serum 25(OH)D level was ˂20 ng/ml. Moreover, omega-3 intake ≤1000 mg/day resulted in higher 25(OH)D levels compared to omega-3 intake1000 mg/day.In conclusion, omega-3 supplementation increased 25(OH)D concentrations, particularly with dosages ≤1000 mg/day and intervention durations8 weeks.

During the last decades, there has been a burst of scientific literature hypothesizing the antioxidant effect of probiotics. However, the results of these studies are inconsistent and a final conclusion has yet to be reached. Thus, the aim of this study was to assess the effects of probiotic/synbiotic supplementation on serum total antioxidant capacity (TAC), glutathione (GSH), malondialdehyde (MDA) and nitric oxide (NO) levels in adults.The following online databases were searched until August 26th 2020: PubMed/Medline, Scopus, Clarivate Analytics Web of Science, Cochrane Central Register of Controlled Trials, Science Direct, Google Scholar and Igaku Chuo Zasshi. The effect sizes were expressed as the weighted mean difference (WMD) with 95% confidence intervals (CI). A total of 31 eligible trials with 1681 participants (839 cases and 842 controls) were included in this meta-analysis. The results revealed that the supplementation with probiotics/synbiotics, significantly increased serum TAC (WMD: 54.14 mmol/L, 95% CI: 27.87, 80.40, P 0.001), GSH (WMD: 40.38 μmol/L, 95% CI: 20.72, 60.03, P 0.001) and NO (WMD: 3.54 μmol/L, 95% CI: 1.73, 5.34, P 0.001) levels. In addition, MDA levels were significantly reduced (WMD: -0.45 μmol/L, 95% CI: -0.58,-0.32, P 0.001) following probiotic/synbiotic supplementation. None of the variables showed a significant change in the sensitivity analysis.Available evidence suggests that probiotic/synbiotic supplementation can significantly increase serum TAC, GSH and NO, as well as reduce MDA levels in adults. Therefore, probiotic/synbiotic supplementation may play a role in improving antioxidant indices and reducing oxidative stress in the body.

The intestinal microbiota represents an interesting and emergent field of research, with already known implications in metabolic and immunological functions. Recently, there is increasing evidence that specific gut microbial populations are associated with cardiovascular diseases. Numerous completed and ongoing studies aim to evaluate the potential of intestinal microbiota assessment to improve the prevention, diagnosis, and therapeutic arsenal of cardiovascular diseases, considering dysbiosis as a cardiovascular risk factor. There is strong evidence for a correlation between intestinal flora imbalance and metabolic changes secondary to bacterial metabolites. In this minireview, we discuss recent data about the connections between intestinal microbiota and cardiovascular disease.

BACKGROUND Obesity and diabetes are associated with high levels of oxidative stress. In Romanian patients with obesity and (or) diabetes, this association has not been sufficiently explored. AIM To evaluate oxidative stress in obese and (or) diabetic subjects and to investigate the possible correlations between oxidative stress and anthropometric/biochemical parameters. METHODS Oxidative stress was evaluated from a single drop of capillary blood. Reactive oxygen species (ROS) were evaluated using the free oxygen radical test (FORT). The free oxygen radical defence (FORD) assay was used to measure antioxidant levels. RESULTS FORT levels were higher in obese subjects (3.04 ± 0.36 mmol/L H2O2) vs controls (2.03 ± 0.14 mmol/L H2O2) (P < 0.0001). FORD levels were lower in obese subjects (1.27 ± 0.13 mmol/L Trolox) vs controls (1.87 ± 1.20 mmol/L Trolox) (P = 0.0072). Obese diabetic subjects had higher FORT values (3.16 ± 0.39 mmol/L H2O2) vs non-diabetic counterparts (2.99 ± 0.33 mmol/L H2O2) (P = 0.0233). In obese subjects, FORT values correlated positively with body mass index (BMI) (r = 0.48, P = 0.0000), waist circumference (WC) (r = 0.31, P = 0.0018), fasting plasma glucose (FPG) (r = 0.31, P = 0.0017), total cholesterol (TC) (r = 0.27, P = 0.0068) and uric acid (r = 0.36, P = 0.0001). FORD values correlated negatively with BMI (r = -0.43, P = 0.00001), WC (r = -0.28, P = 0.0049), FPG (r = -0.25, P = 0.0130), TC (r = -0.23, P = 0.0198) and uric acid (r = -0.35, P = 0.0002). In obese diabetic subjects, FORT values correlated positively with BMI (r = 0.49, P = 0.0034) and TC (r = 0.54, P = 0.0217). FORD values were negatively associated with BMI (r = -0.54, P = 0.0217) and TC (r = -0.58, P = 0.0121). CONCLUSION Oxidative stress levels, as measured by the FORT and FORD assays, were higher in obese subjects vs controls. ROS levels were elevated in diabetic obese patients vs obese non-diabetic patients and controls.

In the last 50 years, several clinical and epidemiological studies during have shown that increased levels of low-density lipoprotein cholesterol (LDLc) are associated with the development and progression of atherosclerotic lesions. The discovery of β-Hydroxy β-methylglutaryl-CoA reductase inhibitors (statins), that possess LDLc-lowering effects, lead to a true revolution in the prevention and treatment of cardiovascular diseases. Statins remain the cornerstone of LDLc-lowering therapy. Lipid-lowering drugs, such as ezetimibe and bile acid sequestrants, are prescribed either in combination with statins or in monotherapy (in the setting of statin intolerance or contraindications to statins). Microsomal triglyceride transfer protein inhibitors and protein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are other drug classes which have been investigated for their potential to decrease LDLc. PCSK9 have been approved for the treatment of hypercholesterolemia and for the secondary prevention of cardiovascular events. The present narrative review discusses the latest (2019) guidelines of the European Atherosclerosis Society/European Society of Cardiology for the management of dyslipidemia, focusing on LDLc-lowering drugs that are either already available on the market or under development. We also consider “whom, when and how” do we treat in terms of LDLc reduction in the daily clinical practice.

The effect of supplementation with zinc on levels of IGF-1 remains relatively unexplored, and many of previous studies have reported equivocal findings. Thus, the aim of this study was to elucidate the influence of zinc on IGF-1. A complete systematic search was executed in Scopus, Web of Science, Embase, and PubMed/MEDLINE, by reviewers, from database inception until June 2019. Weighted mean difference (WMD) with the 95% CI was used for assessing the effects of zinc on IGF-1. We evaluated between study heterogeneity using the I-squared and the Q-test statistic. Ten studies reported changes in plasma levels of IGF-1. Combined results ascertained an increase in IGF-1 levels following zinc administration (WMD: 8.620 ng/ml, 95% CI: 1.126, 16.113, I2 = 97.3%). Subgroup analyses demonstrated that zinc intake dosage ≤10 mg/day (WMD: 9.50 ng/ml, 95% CI: 1.47, 17.53) and intervention length ˃8 weeks (WMD: 10.08 ng/ml, 95% CI: 0.67, 19.48) significantly greater increased IGF-1 levels. The present study demonstrated that zinc supplementation can elicit significant increases in IGF-1 in humans. In addition, greater increments were observed when zinc intake dosage was ≤10 mg/day and intervention duration ˃8 weeks. Keywords: Zinc, IGF-1, Humans, Meta-analysis

Very little has been said about young scientists publishing in Journals that are led and carried forward by medical students or recently graduated physicians themselves. What has been said, however, is not always supportive. For some, these Journals should not exist, arguing that medical student research is for the sole purpose of training or rather, it should be aimed at reaching the level of rigor and impact held by other professional journals. For others, the lack of indexing and impact make these Journals a place where potential visibility and recognition is lost. Yet, there is a community of believers who see us as a way to improve science by training the next generation from the onset of their careers. A for-students, by-students Journal is the crossroads between publication, and therefore visibility, of student research, and a training ground for the ins and outs of peer-review and the writing standards held in science and medicine. With time, the rigor and excellence of these journals grows, and indexing follows. We shared exciting news as well as a summary of the articles that we are publishing in this issue.

Background and Objectives: Polypharmacy is associated with drug–drug or food–drug interactions that may pose treatment difficulties. The objective of the study was to investigate the use of polypharmacy in hypertensive patients hospitalized in the Internal Medicine Clinic of a European referral hospital. Materials and Methods: We conducted a retrospective chart review study on patients identified by a database search of discharge diagnoses to assess the use of polypharmacy and identify potential drug-drug and food-drug interactions. Results: In total, 166 hypertensive patients (68.46 ± 12.70 years, range 42–94 years) were compared to 83 normotensive subjects (67.82 ± 14.47 years, range 22–94 years) who were hospitalized in the clinic during the same period. Polypharmacy was more common in hypertensive versus normotensive subjects (p = 0.007). There were no differences in terms of age, as well as major (0.44 ± 0.77 versus 0.37 ± 0.73 interactions/patient, p = 0.52) and minor (1.25 ± 1.50 versus 1.08 ± 1.84 interactions/patient, p = 0.46) drug–drug interactions between patients with and without hypertension. The mean number of drug–drug interactions (6.55 ± 5.82 versus 4.93 ± 5.59 interactions/patient, p = 0.03), moderate drug–drug interactions (4.94 ± 4.75 versus 3.54 ± 4.17, p = 0.02) and food–drug interactions (2.64 ± 1.29 versus 2.02 ± 1.73, p = 0.00) was higher in patients with hypertension versus their counterparts. Conclusions: The present study reinforces that polypharmacy is a serious concern in hypertensive patients, as reflected by the high number of potentially harmful drug–drug or food–drug interactions. We recorded higher numbers of comorbidities, prescribed drugs, and moderate drug–drug/food–drug interactions in hypertensive versus normotensive patients. A strategy to evaluate the number of discharge medications and reduce drug–drug interactions is essential for the safety of hypertensive patients.

Obesity is a multifactorial disease in which oxidative stress and inflammation play important roles. The aim of our study was to evaluate oxidative stress levels and inflammation markers in obese subjects vs. controls and to investigate the relationship between these values. We found increased levels of reactive oxygen species and inflammation markers (fibrinogen, ferritin, CRP, NLR) and decreased levels of antioxidants in obese subjects vs. controls.

Benign metastasizing leiomyoma is a rare condition usually affecting women of reproductive age with a history of uterine leiomyoma and characterized by soft tissue masses in various extrauterine sites. We report a case of a 46-year-old woman with previously resected uterine leiomyoma with subsequent pulmonary and tricuspid valve lesions. (Level of Difficulty: Intermediate.), Graphical abstract, Benign metastasizing leiomyoma is a rare condition usually affecting women of reproductive age with a history of uterine leiomyoma…

Essential thrombocythemia (ET) is a Philadelphia-negative chronic myeloproliferative neoplasm characterized by acquired somatic mutations: JAK2, CALR or MPL. It is associated with low-grade chronic inflammation, oxidative stress, overproduction of reactive oxygen species (ROS) and antioxidant deficiency. In ET, chronic inflammation and oxidative stress contribute to the genomic instability, the clonal evolution to myelofibrosis and the leukemic transformation. We evaluated ROS levels and the total antioxidant capacity (TAC) in 62 ET patients and investigated the relationship between ROS, TAC, chronic inflammation, leukocytosis, JAK2V617F mutation, and disease progression to myelofibrosis or leukemic transformation. We observed increased levels of ROS and inflammation markers and a decreased TAC in ET patients vs. controls. The acute myeloid leukaemia transformation associated increased levels of oxidative stress and inflammation markers and increased leukocyte counts, while myelofibrosis progression associated an increase in ROS and serum ferritin.

Chronic myeloid leukemia (CML) is a chronic myeloproliferative neoplasm characterized by the presence of the Philadelphia chromosome. Oxidative stress is involved in CML etiopathogenesis and disease progression, as well as the response to tyrosine kinase inhibitors (TKI) treatment. We evaluated oxidative stress levels in 47 CML patients vs. controls. The total antioxidant capacity (TAC) was measured using a FLUOstar Omega microplate reader (reagents from Sigma-Aldrich). Cellular reactive oxygen species (ROS) were evaluated using a CyFlow SPACE Sysmex flow-cytometer (reagents from Abcam). Oxidative stress levels were higher in CML patients vs. controls. The maximum TAC value and the minimum ROS value were recorded in CML patients with a BCR-ABL1 transcript value of 0.1-1%, suggesting that the production of plasma antioxidants progressively increases as a compensatory mechanism in CML patients undergoing TKI treatment in order to annihilate ROS. The pseudonormalization of the cell redox status observed in these patients could be an alarm signal prior to the development of resistance to TKI treatment or disease progression.

Essential thrombocythemia (ET) is a BCR-ABL1-negative myeloproliferative neoplasm associated with thrombotic and haemorrhagic complications. Reactive oxygen species (ROS) overexpression induces a growth advantage to JAK2V617F-positive clones and, in association with a higher number of immature platelets, leukocytosis, and additional cardiovascular risk factors, leads to an increased risk for thrombotic events. We evaluated oxidative stress by measuring ROS levels and the total antioxidant capacity (TAC) in 62 ET patients and investigated the relationship between oxidative stress, JAK2V617F mutational status and the development of thrombotic events. We found higher oxidative stress levels in JAK2V617F-positive vs. JAK2V617F-negative ET cases with no significant differences between homozygous and heterozygous genotypes. Increased ROS levels and thrombotic events were more frequent in ET patients with old age at diagnosis, higher haematocrit levels or leukocytosis.

The association between elevated values of reactive oxygen species and a decreased antioxidant capacity defines oxidative stress. Oxidative stress involvement is blamed in many diseases, including obesity. We evaluated oxidative stress levels by FORT (Free Oxygen Radical Testing � reactive oxygen species levels) and FORD (Free Oxygen Radical Defence � antioxidant capacity value) assays in obese subjects vs. controls. FORT values were high and FORD values were low in obese patients vs. controls, notably in obese subjects with comorbidities (diabetes, hypertension, dyslipidaemia, coronary heart disease, anaemia, hepatic steatosis). We found positive correlations between FORT values and total cholesterol, uric acid, triglycerides, LDL, body mass index, HDL/total cholesterol ratio, and negative correlations between FORT and age, HDL. FORD levels correlated oppositely to FORT. Our results suggest that obesity and oxidative stress are linked.

Objective. Atrial fibrillation (AF) in type 2 diabetes mellitus (T2DM) has been little explored so far. However, there are several cardio metabolic risk factors for AF in T2DM patients, such as arterial hypertension, obesity or the metabolic syndrome. Our objective was to evaluate cardio metabolic risk factors for AF in T2DM patients. Methods. We studied the medical records of T2DM patients hospitalized in the Internal Medicine department of an emergency referral hospital in Bucharest, Romania. The study was observational, retrospective and carried out between January-June 2018. Results. The study group included 221 T2DM patients (with a mean age of 68.65 ± 10.64, ranging between 37-93 years): 116 women (52.49%; with a mean age of 70.53 ± 10.69, ranging between 37-93 years) and 105 men (47.51%; with a mean age of 66.57 ± 10.23, ranging between 38-91 years). 92 patients had AF (41.63%): 40 women (34.48%) and 52 men (49.52%). 180 patients (81.45%) were hypertensive: 103 women (88.79%) and 77 men (73.33%). 113 patients (51.13%) had metabolic syndrome: 58 women (50.00%) and 55 men (52.38%). 77 patients (34.84%) were obese: 45 women (38.79%) and 32 men (30.48%). AF patients associated obesity in 26 cases (28.26%), hypertension in 73 cases (79.35%) and metabolic syndrome in 56 cases (60.87%). Conclusions. Out of the study group, 92 T2DM patients (41.63%) had AF, men being more likely to suffer from AF than women (p=0.0288). Hypertension affected 180 patients (81.45%) and in greater proportion women vs. men (p=0.0051). The metabolic syndrome and obesity were discovered in 113 patients (51.13%) and 77 patients (34.84%), respectively, with no significant differences in terms of gender. In our research, the highest cardio metabolic risk factors for AF in T2DM were hypertension (OR = 3.6675) and the metabolic syndrome (OR = 3.3388).

Diffuse large B-cell lymphoma (DLBCL) is the most common aggressive B-cell non-Hodgkin�s lymphoma. Oxidative stress, defined as an imbalance between the levels of pro-oxidants and the antioxidant defense, is involved in lymphomagenesis via chronic inflammation and is associated with a decrease in circulating levels of high-density lipoprotein (HDL) cholesterol. We evaluated oxidative stress levels in DLBCL patients by FORT (Free Oxygen Radicals Testing) and FORD assays (Free Oxygen Radical Defense), and investigated the relationship between oxidative stress markers and HDL-cholesterol levels. Our results suggest that oxidative stress and decreased levels of HDL-cholesterol might play a role in DLBCL pathogenesis via chronic inflammation.

Introduction: Type 2 diabetes mellitus (T2DM) has been associated with higher rates and poorer prognosis of infections, mainly due to poor glycemic control, reduced response of T-cells and neutrophils, and impaired migration, phagocytosis, and chemotaxis of leukocytes. However, the impact of T2DM on acute cholangitis (AC) has not been assessed so far. Thus, we aimed to explore this association by means of a systematic review of the literature. Methods: This systematic review was carried out based on the recommendations stated in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the PubMed/MEDLINE, Web of Science and SCOPUS databases to identify relevant publications depicting an association between T2DM and AC from the inception of these search services up to present. Results: We detected a total of 435 eligible records. After we applied the inclusion and exclusion criteria, a total of 14 articles were included in the present systematic review. Included manuscripts focused on the potential role of T2DM as a risk factor for the development of AC and on its contribution to a worse prognosis in AC, e.g., development of sepsis or other complications, the risk of AC recurrence and the impact on mortality. Conclusions: As compared to non-diabetic individuals, patients with T2DM have a higher risk of AC as a complication of choledocholithiasis or gallstone pancreatitis. Several oral hypoglycemic drugs used in the management of T2DM may also be involved in the onset of AC. Diabetic patients who suffer from AC have a higher likelihood of longer hospital stays and sepsis, as well as a higher risk of mortality and more severe forms of AC as compared to non-diabetic individuals.

The effect of transdermal 17β-estradiol and norethisterone acetate co-administration on the lipid profile in postmenopausal women remains controversial as randomized controlled trials (RCTs) conducted to investigate this research question have produced conflicting results. Consequently, to clarify this issue, we conducted a systematic review and meta-analysis of RCTs that evaluated the impact of transdermal 17β-estradiol combined with norethisterone acetate treatment on the concentrations of serum lipids in postmenopausal women.Relevant articles published before February 1st, 2022 were identified by searching the PubMed/Medline, Scopus, and Embase, and Web of Science electronic databases. A random-effects model, employing the method of DerSimonian and Laird, was used to evaluate effect sizes, and results were expressed as weighted mean difference (WMD) and 95% confidence intervals (CIs).Pooled results from 7 RCTs with 9 intervention arms demonstrated that transdermal 17β-estradiol combined with norethisterone acetate administration significantly decreased total cholesterol (TC) (WMD: -13.43 mg/dL, 95% CI: -18.11 to -8.75, P 0.001) and low-density lipoprotein cholesterol (LDL-C) (WMD: -13.90 mg/dL, 95% CI: -20.40 to -7.41, P 0.001). In the subgroup analyses, a notable reduction in TC was observed in subjects with baseline TC concentrations ≥ 130 mg/dL (WMD -14.49 mg/dL), when treatment duration was ≤ 6 months (WMD: -17.21 mg/dL), and in participants with a body mass index (BMI) ≥ 25 kg/mBased on our findings, the co-administration of transdermal 17β-estradiol and norethisterone acetate in postmenopausal females can decrease TC and LDL-C levels, as well as TG values, but does not influence HDL-C concentrations.

Background: Soy milk contains some beneficial components such as isoflavones which can exert favorable effects on the cardiovascular health. The current study aimed to comprehensively evaluate the potential effects of soy milk consumption on cardiometabolic risk factors in adults. Methods: Relevant articles published up to June 2020 were systematically retrieved from SCOPUS, PubMed/MEDLINE, EMBASE, and Web of Science databases. In our study, we included all the randomized controlled trials (RCTs) investigating the impact of soy milk consumption on various cardiometabolic risk factors in adults (age � 18 years). A meta-analysis of the eligible studies was performed using the random-effects model. Results: The quantitative meta-analysis of 18 eligible RCTs (665 participants, age range 18�65 years) demonstrated that the consumption of soy milk significantly reduced systolic (P < 0.001) and diastolic (P = 0.002) blood pressure, total (P = 0.001) and low-density lipoprotein (P = 0.041) cholesterol, waist circumference (P = 0.005), C-reactive protein (P < 0.001), and tumor necrosis factor-alpha (P = 0.016). Significant between-study heterogeneity was found for the pooled effect sizes of blood pressure and low-density lipoprotein cholesterol. In addition, the subgroup analyses indicated that the decrease in systolic blood pressure (SBP) was more pronounced when soy milk was consumed for � 4 weeks. However, there were no significant differences between soy milk and control groups for the other factors, namely body weight, body mass index (BMI), high-density lipoprotein cholesterol, triglycerides, fasting blood glucose (FBG), and fasting insulin, interleukin-6, and fibrinogen. Conclusions: The current systematic review and meta-analysis revealed that incorporating soy milk into the diet might favorably affect several cardiometabolic risk factors in both healthy and unhealthy individuals. © 2021 The Authors

Myeloproliferative neoplasms (MPNs) are rare, clonal disorders of the hematopoietic stem cell in which an uncontrolled proliferation of terminally differentiated myeloid cells is noted. Polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF) are included in the category of Philadelphia-negative, so-called classical MPNs. The potential applications of liquid biopsy and liquid biopsy-based biomarkers have not been explored in MPNs until now. Thus, a systematic search was computed in PubMed/MEDLINE, Web of Science and The Cochrane Library and, in total, 198 potentially relevant papers were detected. Following the removal of duplicates (n = 85), 113 records were screened. After the exclusion of irrelevant manuscripts based on the screening of their titles and abstracts (n = 81), we examined the full texts of 33 manuscripts. Finally, after we applied the exclusion and inclusion criteria, 27 original articles were included in this review. Overall, the data analyzed in this review point out that liquid biopsy and liquid biopsy-based biomarkers (cell-free DNA, extracellular vesicles, microparticles, circulating endothelial cells) could be used in MPNs for diagnostic and prognostic purposes. Future research is needed to clarify whether this technique can be employed to differentiate between MPN subtypes and secondary causes of erythrocytosis, thrombocytosis and myelofibrosis, as well as to predict the development of thrombosis.

Background and aim The menopause is associated in females with the presence of dysglycemia, insulin resistance and with the development of endothelial dysfunction. Tibolone (TIB) is a synthetic steroid compound with selective oestrogenic and, to a lesser extent, progestogenic and androgenic properties prescribed to postmenopausal women to alleviate the symptoms of the climaterium and to prevent the development of osteoporosis. However, the impact of TIB on fasting blood sugar (FBS), insulin, Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) index and flow-mediated dilation (FMD) in women has not been evaluated so far. Thus, to investigate this research question, we conducted the present systematic review and meta-analysis. Methods Two independent reviewers searched the Scopus, Web of Science, PubMed/Medline and Embase databases up to 20 December 2020. The weighted mean differences (WMDs) and the 95% confidence intervals (CI) were calculated using the DerSimonian and Laird random effects models between the TIB and control groups and included in the forest plot. Results The overall findings were generated from 12 eligible randomized controlled trials. As compared to controls, TIB administration resulted in a significant reduction of FBS (WMD: −3.06 mg/dL, 95% CI: −5.30 to −0.82, P = 0.007), and of the HOMA-IR index (WMD: −0.61, 95% CI: −1.11 to −0.11, P = 0.01). However, treatment with TIB did not lead to significant changes of the FMD (WMD: 0.78%, 95% CI: −0.20 to 1.77, P = 0.12) or of insulin levels (WMD: −0.10 mIU/L, 95% CI: −2.04 to 1.83, P = 0.91). Conclusion TIB administration can decrease FBS and the HOMA-IR index in postmenopausal women. However, the use of TIB does not influence insulin levels or FMD.

Dyslipidemia is a significant threat to public health worldwide and the identification of its pathogenic mechanisms, as well as novel lipid-lowering agents, are warranted. Magnesium (Mg) is a key element to human health and its deficiency has been linked to the development of lipid abnormalities and related disorders, such as the metabolic syndrome, type 2 diabetes mellitus, or cardiovascular disease. In this review, we explored the associations of Mg (dietary intake, Mg concentrations in the body) and the lipid profile, as well as the impact of Mg supplementation on serum lipids. A systematic search was computed in PubMed/MEDLINE and the Cochrane Library and 3649 potentially relevant papers were detected and screened (n = 3364 following the removal of duplicates). After the removal of irrelevant manuscripts based on the screening of their titles and abstracts (n = 3037), we examined the full-texts of 327 original papers. Finally, after we applied the exclusion and inclusion criteria, a number of 124 original articles were included in this review. Overall, the data analyzed in this review point out an association of Mg concentrations in the body with serum lipids in dyslipidemia and related disorders. However, further research is warranted to clarify whether a higher intake of Mg from the diet or via supplements can influence the lipid profile and exert lipid-lowering actions.

Dyslipidemia/hyperlipidemia is recognized among the risk factors for lifestyle related diseases. A healthy diet, rich in vegetable oils such as rice bran oil (RBO), may aid to improve serum lipid levels. Thus, the aim of this study was to assess the effects of rice bran oil (RBO) consumption on serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c) and triglyceride (TG) levels in adults. The following online databases were searched for manuscripts published until October 7