Fat Tissue Research Articles

High-frequency electric knife smoke particles: An experimental study on factors influencing emission characteristics

During surgery, the use of a high-frequency electric knife produces smoke, which can be harmful to the health of indoor medical staff and patients. The quantity and particle size distribution of smoke particles produced by different tissues may vary. Understanding the release characteristics of these smoke particles is necessary to clarify their impact on the surgical environment and to seek effective smoke control methods. A previous comparative analysis of human and pig tissues revealed that they share similar water and fat compositions in certain anatomical regions. In this study, we investigated the emission characteristics of smoke particles from various tissues of pigs (skeletal muscle, liver, kidney, skin, and subcutaneous fat) under different operating powers of an electric knife. We measured the indoor particle number concentration (particle concentration), and estimated the PM2.5 mass concentration (PM2.5 concentration), particle size distribution, and emission rate of the smoke particles. The study obtained the particle emission rates of different tissues under different electric knife operating powers, results of which showed that (1) during the operation of the electric knife, mainly small particles below 1 μm are produced. Among them, particles of 0.3 μm were the most abundant, with a particle concentration level of up to 109 particles/m3, accounting for 85.17–97.64% of the total particle number, and as the particle size increased, the particle concentration and percentage decreased significantly. (2) The water and fat compositions of different tissues influenced the indoor particle concentration and emission rate of the smoke emitted by the electric knife. Among different tissues, subcutaneous fat tissue had the lowest particle concentration and emission rate. (3) The electric knife operating power mainly affected particles below 1 μm, and except for kidney tissue, the indoor concentration and emission rate of these particle sizes were positively correlated with the power. The experimental results can provide data reference for the use of high-frequency electric knives in surgeries involving different human tissues in the operating room.

The preoperative predictive factors for pathological T3a upstaging and positive surgical margin of clinical T1 renal cell carcinoma

ObjectivesThe objective of this study is predict positive surgical margin (PSM) and pathological T3a (pT3a) upstaging in patients with clinical T1 (cT1) renal cell carcinoma (RCC). Materials and methods159 patients who underwent radical nephrectomy (RN) or partial nephrectomy (PN) for RCC. Patients’ demographic, laboratory, radiological and pathological data that could predict PSM and pT3a upstaging pre-operatively were evaluated. The categorical and continuous variables were compared between the patient groups with or without PSM and/or pT3a upstaging using Pearson’s chi-square test, and independent samples t-test or the Mann-Whitney U test, respectively. ResultsPT3a upstaging was detected in 32 (20.1%) patients, and PSM was detected in 28 (17.6%) patients. PT3a upstaging was detected in 27 and 5 patients who underwent open surgery and laparoscopic surgery, respectively (P < .001). In addition, pT3a upstaging was detected in 6 and 26 patients who underwent RN and PN, respectively (P < .001). Peritumoral fatty tissue thickness was 11.97 and 15.38 in the pT1 and pT3a patient groups, respectively (P = .022). In patients with pT3a upstaging, tumor size was larger, and renal nephrometry score and systemic immune-inflammation index (SII) were higher (P < .001, P < .001, and P = .022, respectively). It was determined that De Ritis ratio (DRR) and albumin-to-alkaline phosphatase (ALP) ratio (AAPR) parameters had significant prognostic values in predicting PSM (P = .024, and P = .001, respectively). ROC analysis indicated that tumor size predicted pT3a upstaging with 100% sensitivity and 98.6% specificity when its cut-off value was taken as 6.85 mm (AUC: 1.000, P < .001). In addition, logistic regression analysis revealed AAPR and DRR as significant predictors of PSM (P < .001, and P = .009, repsectively). ConclusionThe findings of this study indicated that the surgical technique of choice and the type of operation, tumor size, RNS value, peritumoral fatty tissue thickness, HU values of peritumoral and tumor side fatty tissues, and DRR and SII values can predict pT3a upstaging of patients with cT1 RCC, and that AAPR and DRR values can predict PSM.

Localized scleroderma

Localized scleroderma (LS), also called circumscribed scleroderma or morphea, comprises aheterogeneous group of diseases that can be classified into four subtypes: limited, linear, generalized, and mixed LS. All manifestations are primarily due to chronic progressive fibrosis of the skin or structures close to the skin. Involvement of internal organs or the transition to systemic sclerosis is excluded by definition. Adistinction is made between forms that primarily affect the skin (up to the dermis) or that severely involve subcutaneous fat tissue, muscle fascia or muscles. Adetailed examination is required for clinical diagnosis. In order to improve comparability of findings, photo documentation and the use of clinical scores should be carried out. For superficial subtypes the use of topical glucocorticosteroids, calcineurin inhibitors or phototherapy is initially recommended, whereas for severe forms with deep involvement or overall therapy refractoriness, the diagnosis should first be expanded and systemic therapy initiated at an early stage. Especially, in cross joint or extremity-dominant forms of linear LS or in cases with head and neck involvement, such as en coup de sabre, Parry-Romberg syndrome and other subtypes with aprominent musculoskeletal affection, an MRI examination should be arranged. Depending on location, an ophthalmological, neurological, orthodontic, rheumatological or orthopedic consultation may be necessary. For systemic therapy, methotrexate alone or in combination with systemic glucocorticosteroids as pulse therapy is recommended as first-line treatment.

How to Treat a Cyclist's Nodule?-Introduction of a Novel, ICG-Assisted Approach.

Perineal nodular induration (PNI) is a benign proliferation of the soft tissue in the perineal region that is associated with saddle sports, especially road cycling. The etiology has not been conclusively clarified; however, repeated microtrauma to the collagen and subcutaneous fat tissue by pressure, vibration and shear forces is considered a mechanical pathomechanism. In this context, chronic lymphedema resulting in the development of fibrous tissue has been suggested as an etiological pathway of PNI. The primary aim of this study was to introduce and elucidate a novel operative technique regarding PNI that is assisted by indocyanine green (ICG). In order to provide some context for this approach, we conducted a comprehensive review of the existing literature. This dual objective aimed to contribute to the existing body of knowledge while introducing an innovative surgical approach for managing PNI. We reviewed publications relating to PNI published between 1990 and 2023. In addition to the thorough review of the literature, we presented our novel surgical approach. We described how this elaborate approach for extensive cases of PNI involves surgical excision combined with tissue doubling and intraoperative ICG visualization for exact lymphatic vessel obliteration to minimize the risk of recurrence based on the presumed context of lymphatic congestion. The literature research yielded 16 PubMed articles encompassing 23 cases of perineal nodular induration (PNI) or cyclist's nodule. Of these, 9 cases involved females, and 14 involved males. Conservative treatment was documented in 7 cases (30%), while surgical approaches were reported in 16 cases (70%). Notably, a limited number of articles focused on histopathological or radiological characteristics, with a shortage of structured reviews on surgical treatment options. Only two articles provided detailed insights into surgical techniques. Similarly to the two cases of surgical intervention identified in the literature research, the post-operative recovery in our ICG assisted surgical approach was prompt, meaning a return to cycling was possible six weeks after surgery. At the end of the observation period (twelve months after surgery), regular scar formation and no signs of recurrence were seen. We hope that this article draws attention to the condition of PNI in times of increasing popularity of cycling as a sport. We aimed to contribute to the existing body of knowledge through our thorough review of the existing literature while introducing an innovative surgical approach for managing PNI. Due to the successful outcome, the combination of tissue doubling, intraoperative ICG visualization and postoperative negative wound therapy should be considered as a therapeutic strategy in cases of large PNI.

A Case Report on Iatrogenic Cushing Syndrome with Diabetes Mellitus

Cushing syndrome (CS) is a condition caused due to high levels of cortisol in which weight gain and fat tissue build-up take place. Generally, patients with Cushing syndrome also suffer from diabetes. A 57-year-old female patient with aggravated cortisol levels. Laboratory investigations of the patient were performed and they showed decreased haemoglobin levels, but increased vitamin B12 levels, and TSH levels. The patient was prescribed a combination of medications to manage anemia, anemia, and diabetes. The patient's medical history included splenomegaly, cholelithiasis, panniculitis, and kidney enlargement. The patient's diabetes was responding well to the treatment and was better after 10 days.&#x0D; Keywords: Cushing syndrome, Diabetes mellitus, corticosteroid.

Transcriptional control of CCAAT/enhancer binding protein zeta gene in chicken adipose tissue

CCAAT/enhancer binding protein zeta (C/EBPZ) was differentially expressed in abdominal adipose tissues of fat and lean broilers and regulated adipogenesis in chicken. The objective of this study was to elucidate the transcriptional regulation of C/EBPZ gene in chicken adipose tissue. A 2,031-base pair (bp) chicken C/EBPZ sequence (2,025 nucleotides upstream to 6 nucleotides downstream from the initiator codon, -2,025/+6) was studied. The sequence exhibited a significant promoter activity (P < 0.05) and had some cis-acting elements, notably, a core promoter was identified in nucleotides -94 to +6. Additionally, DNA pull-down assay showed that proteins interacted with chicken C/EBPZ promoter (-173/+6) in preadipocytes were implicated in transcription, post-transcriptional regulation and translation. In addition, KLF2 facilitated the activities of chicken C/EBPZ promoter (-2,025/+6, -1,409/+6, -793/+6, -485/+6, -173/+6, and -94/+6) in preadipocytes (P < 0.05). The expression levels of KLF2 and C/EBPZ in chicken abdominal adipose tissue were substantially associated (r = 0.5978278, P < 0.0001), and KLF2 increased C/EBPZ expression in vitro (P < 0.05). Additionally, chromatin immunoprecipitation (ChIP)-PCR analysis revealed that KLF2 has the ability to interact with the chicken C/EBPZ promoter regions at least at the positions -1,245/-1,048 and -571/-397. Mutation analysis showed that the CGCAGCGCCCG motif located in the chicken C/EBPZ promoter at positions -45 to -35 is involved in regulating transcription and facilitates trans activation by KLF2. These results provided some information of transcription control of C/EBPZ in chicken adipose tissue.

A giant, recurrent, subpectoral breast lipoma: case report

Lipomas are mesenchymal tumors composed of mature fat tissue and are considered one of the most common benign tumors. They are usually small in size, and giant lipomas are rare. The exact etiology of lipoma development is unclear, though several factors have been proposed. Intramuscular or subpectoral lipomas involving the pectoralis major muscle are uncommon. In this report, the author has described the case of a 52-year-old female patient who presented with an uncommon form of subpectoral, giant, recurrent breast lipoma. The patient had undergone a complete surgical excision. The author suggests an individualized assessment and treatment of each case.

The application value of LAVA-flex sequences in enhanced MRI scans of nasopharyngeal carcinoma: comparison with T1WI-IDEAL.

Magnetic resonance imaging (MRI) staging scans are critical for the diagnosis and treatment of patients with nasopharyngeal cancer (NPC). We aimed to evaluate the application value of LAVA-Flex and T1WI-IDEAL sequences in MRI staging scans. Eighty-four newly diagnosed NPC patients underwent both LAVA-Flex and T1WI-IDEAL sequences during MRI examinations. Two radiologists independently scored the acquisitions of image quality, fat suppression quality, artifacts, vascular and nerve display. The obtained scores were compared using the Wilcoxon signed rank test. According to the signal intensity (SI) measurements, the uniformity of fat suppression, contrast between tumor lesions and subcutaneous fat tissue, and signal-to-noise ratio (SNR) were compared by the paired t-test. Compared to the T1WI-IDEAL sequence, LAVA-Flex exhibited fewer artifacts (P<0.05), better visualization of nerves and vessels (P<0.05), and performed superior in the fat contrast ratio of the primary lesion and metastatic lymph nodes (0.80 vs. 0.52, 0.81 vs. 0.56, separately, P<0.001). There was no statistically significant difference in overall image quality, tumor signal-to-noise ratio (SNR), muscle SNR, and the detection rate of lesions between the two sequences (P>0.05). T1WI-IDEAL was superior to LAVA-Flex in the evaluation of fat suppression uniformity (P<0.05). LAVA-Flex sequence provides satisfactory image quality and better visualization of nerves and vessels for NPC with shorter scanning times.

A Rare Entity: Coexistence of Acute Appendicitis and Cecal Diverticulitis

In this case report, we wanted to present the diagnostic and treatment process of a patient who was diagnosed with acute appendicitis in the preoperative period, was taken to surgery, and was diagnosed with cecum diverticulitis in the perioperative period. A 36-year-old female patient was admitted to our emergency department with complaints of abdominal pain, nausea, and loss of appetite for 3 days. Abdominal pain started in the lower right abdomen and gradually increased in severity as the day passed. On physical examination, there was defense and rebound localized to the lower right quadrant of the abdomen. In the laboratory, the white blood cell count was within normal limits (7.4 10*9 L-1) and the c-reactive protein (CRP) level was 79 mg L-1 (0-5 mg L-1). On abdominal ultrasonography, the diameter of the appendix vermiformis was measured as 8.5 mm, and it was observed that there was increased echogenicity in the fatty tissue around the appendix vermiformis. The patient was taken to emergency surgery. During exploration, the appendix was observed to be oedematous. Additionally, diverticulitis was observed in the anterior wall of the cecum, close to the ileocecal area. Simultaneous appendectomy and diverticulectomy were performed. The patient was discharged without complications on the 4th postoperative day.

Sex-Specific Effects of Long-Term Antipsychotic Drug Treatment on Adipocyte Tissue and the Crosstalk to Liver and Brain in Rats.

Antipsychotic drug (APD) medication can lead to metabolic dysfunctions and weight gain, which together increase morbidity and mortality. Metabolically active visceral adipose tissue (VAT) in particular plays a crucial role in the etiopathology of these metabolic dysregulations. Here, we studied the effect of 12 weeks of drug medication by daily oral feeding of clozapine and haloperidol on the perirenal fat tissue as part of VAT of male and female Sprague Dawley rats in the context of complex former investigations on brain, liver, and blood. Adipocyte area values were determined, as well as triglycerides, non-esterified fatty acids (NEFAs), glucose, glycogen, lactate, malondialdehyde equivalents, ferric iron and protein levels of Perilipin-A, hormone-sensitive-lipase (HSL), hepcidin, glucose transporter-4 (Glut-4) and insulin receptor-ß (IR-ß). We found increased adipocyte mass in males, with slightly higher adipocyte area values in both males and females under clozapine treatment. Triglycerides, NEFAs, glucose and oxidative stress in the medicated groups were unchanged or slightly decreased. In contrast to controls and haloperidol-medicated rats, perirenal adipocyte mass and serum leptin levels were not correlated under clozapine. Protein expressions of perilipin-A, Glut-4 and HSL were decreased under clozapine treatment. IR-ß expression changed sex-specifically in the clozapine-medicated groups associated with higher hepcidin levels in the perirenal adipose tissue of clozapine-treated females. Taken together, clozapine and haloperidol had a smaller effect than expected on perirenal adipose tissue. The perirenal adipose tissue shows only weak changes in lipid and glucose metabolism. The main changes can be seen in the proteins examined, and probably in their effect on liver metabolism.

32. IMPACT OF SURGERY ON BODY COMPOSITION IN PATIENTS UNDERGOING COLECTOMY FOR COLON CANCER IN AN ERAS PROGRAM

Abstract Introduction The prevalence of sarcopenia in CC patients undergoing colon cancer surgery is high and is associated with increased morbi-mortality. However, there are few studies assessing the impact of surgery on body composition. The main objective of this study was to analyze changes in body composition after colectomy for CC. Methods Observational, retrospective study in which patients operated on for CC by RICA route between December 2019 and June 2022 were collected. Pre- and post-surgical measurement of skeletal muscle index (SMI), Psoas iliacus index (PI), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) of each patient was performed by computed tomography (CT). In addition, the influence of previous nutritional assessment and postoperative supplementation on body composition variation was analyzed. Results After surgery, SMI, PI, VAT, and SAT significantly decreased in patients. Moreover, the number of patients with sarcopenia increased significantly. Although no statistically significant differences were identified, patients who did not receive preoperative nutritional supplementation exhibited a greater decrease in muscle mass and fat tissue, along with a higher tendency for postoperative complications. Conclusion Surgical intervention presents a negative impact on body composition in patients with CC with a significant decrease in muscle mass and visceral and subcutaneous fat. Preoperative nutritional optimization could buffer this loss with a consequent decrease in associated complications.

Genome-wide characterization and comparison of endogenous retroviruses among 3 duck reference genomes

Endogenous retroviruses (ERV) are viral genomes integrated into the host genome and can be stably inherited. Although ERV sequences have been reported in some avian species' genome, the duck endogenous retroviruses (DERV) genome has yet to be quantified. This study aimed to identify ERV sequences and characterize genes near ERVs in the duck genome by utilizing LTRhavest and LTRdigest tools to forecast the duck genome and analyze the distribution of ERV copies. The results revealed 1,607, 2,031, and 1,908 full-length ERV copies in the Pekin duck (ZJU1.0), Mallard (CAU_wild_1.0), and Shaoxing duck (CAU_laying_1.0) genomes, respectively, with average lengths of 7,046, 7,027, and 6,945 bp. ERVs are mainly distributed on the 1, 2, and sex chromosomes. Phylogenetic analysis demonstrated the presence of Betaretrovirus in 3 duck genomes, whereas Alpharetrovirus was exclusively identified in the Shaoxing duck genome. Through screening, 596, 315, and 343 genes adjacent to ERV were identified in 3 duck genomes, respectively, and their functions of ERV neighboring genes were predicted. Functional enrichment analysis of ERV-adjacent genes revealed enrichment for Focal adhesion, Calcium signaling pathway, and Adherens junction in 3 duck genomes. The overlapped genes were highly expressed in 8 tissues (brain, fat, heart, kidney, liver, lung, skin, and spleen) of 8-wk-old Mallard, revealing their important expression in different tissues. Our study provides a new perspective for understanding the quantity and function of DERVs, and may also provide important clues for regulating nearby genes and affecting the traits of organisms.

Distribution of Pesticides and Polychlorinated Biphenyls in Food of Animal Origin in Croatia.

Pesticides and polychlorinated biphenyls (PCBs) are persistent environmental pollutants. When entering the food chain, they can represent a public health problem due to their negative effects on health. In this study, concentrations of organochlorine pesticides (OCPs), organophosphate pesticides (OPPs), pyrethroids, carbamates, and PCBs-a total 73 compounds-were determined in a total of 2268 samples of fat tissues (beef, pork, sheep, goat, poultry, game, horse, rabbit) and processed fat, meat, and processed meat products collected in Croatia during an 8-year period. In fatty tissues, 787 results exceeded the limits of quantification (LOQ): 16 OCPs, eight OPPs, six pyrethroids, one carbamate, and seven PCBs. The most positive results in fat samples were found for OCPs, with a frequency of quantification in the range of 57.5-87.5%. Hexachlorobenzene (HCB) and dichlorodiphenyldichloroethylene (DDE) were quantified in the highest percentages, in the ranges of 5.5-66.7% and 5.4-55.8%. Concentrations above the MRL values were determined for chlorpyrifos in pork fat and for resmethrin in six fat samples and one pâté. In 984 samples of meat and meat products, only 62 results exceeded the LOQ values. The highest frequency of quantification was determined for OCPs (25 samples), of which 40% were DDT isomers (60% DDE). Frequency quantifications of PCBs in fat samples were between 7.23 and 36.7%. An evaluation of the health risk assessment showed that the consumption of fat, meat, and meat products does not pose a threat to consumer health, since all EDI values were well below the respective toxicological reference values.

Postbiotic potential of Bacillus velezensis KMU01 cell-free supernatant for the alleviation of obesity in mice

Attention toward the preventive effects of postbiotics on metabolic diseases has increased because of greater stability and safety over probiotics. However, studies regarding the bioactive effects of postbiotics, especially from probiotic Bacillus strains, are relatively limited. The anti-obesity effects of the cell-free culture supernatant of Bacillus velezensis KMU01 (CFS–B.vele) were evaluated using high-fat-diet (HFD)-induced mice. HFD-induced mice (n = 8 per group) received equal volumes of (1) CFS-B.vele (114 mg/kg) in PBS, (2) Xenical in PBS, or (3) PBS alone by oral gavage daily for 13 weeks. The results demonstrated that CFS-B.vele changed the gut microbiota and showed anti-obesity effects in HFD-induced obese mice. The elevated Firmicutes/Bacteroidota ratio induced by HFD was decreased in the CFS-B.vele group compared to the other groups (p < 0.05). The CFS-B.vele intervention led to the enrichment of SCFA-producers, such as Roseburia and Eubacterium, in the cecum, suggesting their potential involvement in the amelioration of obesity. Due to these changes, the various obesity-related biomarkers (body weight, fat in tissue, white adipose tissue weight and size, serum LDL-cholesterol level, hepatic lipid accumulation, and adipogenesis/lipogenesis-related gene/protein expression) were improved. Our findings suggest that CFS-B.vele has potential as a novel anti-obesity agent through modulation of the gut microbiota.

Biomimetic-Membrane-Protected Plasmonic Nanostructures as Dual-Modality Contrast Agents for Correlated Surface-Enhanced Raman Scattering and Photoacoustic Detection of Hidden Tumor Lesions.

Optical imaging and spectroscopic modalities are of considerable current interest for in vivo cancer detection and image-guided surgery, but the turbid or scattering nature of biomedical tissues has severely limited their abilities to detect buried or occluded tumor lesions. Here we report the development of a dual-modality plasmonic nanostructure based on colloidal gold nanostars (AuNSs) for simultaneous surface-enhanced Raman scattering (SERS) and photoacoustic (PA) detection of tumor phantoms embedded (hidden) in ex vivo animal tissues. By using red blood cell membranes as a naturally derived biomimetic coating, we show that this class of dual-modality contrast agents can provide both Raman spectroscopic and PA signals for the detection and differentiation of hidden solid tumors with greatly improved depths of tissue penetration. Compared to previous polymer-coated AuNSs, the biomimetic coatings are also able to minimize protein adsorption and cellular uptake when exposed to human plasma without compromising their SERS or PA signals. We further show that tumor-targeting peptides (such as cyclic RGD) can be noncovalently inserted for targeting the ανβ3-integrin receptors expressed on metastatic cancer cells and tracked via both SERS and PA imaging (PAI). Finally, we demonstrate image-guided resections of tumor-mimicking phantoms comprising metastatic tumor cells buried under layers of skin and fat tissues (6 mm in thickness). Specifically, PAI was used to determine the precise tumor location, while SERS spectroscopic signals were used for tumor identification and differentiation. This work opens the possibility of using these biomimetic dual-modality nanoparticles with superior signal and biological stability for intraoperative cancer detection and resection.

Addressing the structural sophistication of meat via plant-based tissue engineering

The escalating environmental impact of traditional livestock farming, particularly beef production, has spurred the search for sustainable meat alternatives. This study introduces a novel Plant-Based Tissue Engineering (PBTE) approach, to replicate the complex structure and sensory experience of whole-muscle cuts of meat using plant-based ingredients. Leveraging principles of tissue engineering and advanced food manufacturing technologies, PBTE deconstructs meat into its fundamental components: muscle, fat, and connective tissue, and reconstructs them using a combination of plant proteins, fats and polysaccharide materials. The muscle component is reassembled to mimic the anisotropic fibrous structure of beef, while the fat component is engineered through lipid encapsulation within a hydrocolloid matrix. Advanced manufacturing techniques, including additive manufacturing and robotics, are utilized for precise spatial configuration and assembly of these components. Our findings demonstrate that PBTE can effectively replicate the mechanical integrity, texture, and sensory attributes of traditional meat, presenting a promising alternative that could significantly reduce the environmental footprint of meat production. This approach aligns with the principles of Soft Matter in the manipulation of artificial structures and materials for mimicking naturally occurring designs, such as whole cut meat foods. It also holds substantial potential for revolutionizing the alternative protein industry by catering to a broader consumer base, including flexitarians and meat-eaters.

Effect of perioperative forced air warming blanket on older adult patients undergoing spinal surgery with general anesthesia.

As the population of patients aged 65 years and older increases, the number of older adult patients undergoing surgery also increases. Older adults are vulnerable to hypothermia due to age-related changes in the thermoregulatory center, which leads to reduced subcutaneous fat tissue, vasomotor response, and heat production. Thus, they are more likely to suffer complications, including cardiovascular changes, blood coagulation disorders, infections, and delayed recovery from surgery. The study investigated the effect of preventive active warming. This retrospective cohort study conducted at Chungbuk National University Hospital investigated clinical data from older adult patients undergoing spinal surgery from January 1, 2020, to December 13, 2022. In this study, we explored the use of prophylactic active warming during anesthesia induction and post-surgery warming in older adult patients (≥65 years) who experienced hypothermia during and after surgery under general anesthesia. The control group of patients who experienced hypothermia increased from 20% after 10 minutes to 80% after 30 minutes and 100% after 60 minutes. The percentage of patients in the treatment group who initially experienced hypothermia increased from 10% after 30 min to 40% after 60 minutes. However, notably, 90% of these patients had returned to a normal body temperature upon their arrival at the recovery room. The difference in the percentage of patients who developed hypothermia was statistically significant between the two groups. Hypothermia prevention via an air-forced warming blanket was effective for older adult patients undergoing spinal surgery under general anesthesia.

Supplementation of Nutraceuticals from Dwarf Kiwi and Apple Improves Lipid Profile in Overweight Adults

(1) Background: Overweight and obesity are emerging global problems causing multiple health complications. Excessive fat tissue content leads to chronic inflammation, which is why antioxidative compounds that could potentially reduce these processes are possible agents that could be supplemented in order to prevent metabolic complications of overweight and obesity. Apples and dwarf kiwis are good sources of antioxidative agents such as quercetin and chlorogenic acid. The aim of this study was to assess if apple and dwarf kiwi nutraceutical supplementation can improve the metabolic parameters of overweight adults. (2) Methods: 43 participants were enrolled in the double-blinded pilot study: 21 in the supplementation group and 22 in the placebo group. The one 1000 mg nutraceutical capsule contained 10% Chopin apple peel extract, 10% whole dwarf kiwi fruit extract, 75% Chopin apple core extract, and 5% rapeseed peptides. The supplementation group received two capsules/day for 60 days. (3) Results: The supplementation of the apple and kiwi product resulted in a lowering of ALT in the supplementation group (from 29.65 ± 19.02 UI/L to 23.80 ± 13.76 UI/L; p = 0.01). Subgroup analysis in men and women showed a significant decrease in total cholesterol level (from 220.15 ± 36.69 mg/dL to 208.43 ± 37.09 mg/dL; p = 0.04), non-HDL cholesterol (from 161.17 ± 41.00 mg/dL to 145.69 ± 41.75 mg/dL; p = 0.02) and ALT (from 25.41 ± 12.05 UI/L to 19.07 ± 6.13 UI/L; p = 0.01) in women and triglycerides levels (from 212.74 ± 127.15 mg/dL to 155.63 ± 80.61 mg/dL; p = 0.047) in men. (4) Conclusions: The supplementation of nutraceuticals from apples and dwarf kiwi led to improvements in lipid profile. It can be a possible new agent for counteracting overweight metabolic complications, however, larger group studies and more detailed tests are needed to support these preliminary findings.

The evaluation of retrobulbar fat tissue in Graves' orbitopathy with shear-wave ultrasound elastography.

To evaluate retrobulbar adipose tissue of patients with active and inactive Graves' orbitopathy (GO) by shear-wave ultrasound elastography (SWE). Followed-up in our ophthalmology clinic due to GO, 72 eyes of 36 patients and 38 eyes of 19 healthy controls were included in this cross-sectional case-control study. Graves' patients were divided into two subgroups under clinical activity score (CAS): active Graves' orbitopathy (AGO) (CAS ≥ 3) and inactive Graves' orbitopathy (IGO) (CAS < 3). SWE measurement values of retrobulbar adipose tissue of all participants were recorded in meters/second, and the intergroup comparisons were performed. Thirty-four eyes of 17 patients in AGO, 38 eyes of 19 patients in IGO, and 38 eyes of 19 participants in the control group were included in the study. Mean values measured from retrobulbar adipose tissue through SWE were 1.00 ± 0.01m/sec in AGO, 1.16 ± 0.01m/sec in IGO, and 0.94 ± 0.01m/sec in the control groups. Even so, the mean SWE value was significantly higher in the IGO group than in the other groups (p < 0.001). Mean SWE values were significantly higher in the AGO group than in the controls (p = 0.008). In the correlation analysis performed, a significant positive correlation was found between SWE and Hertel exophthalmometer measurement values (p = 0.026, r = 0.212), and thyroid-stimulating hormone receptor antibody (TSHR-Ab) levels (p = 0.018, r = 0.224). We detected SWE values of retrobulbar adipose tissue high in GO, especially in the IGO group. Such a situation, which we associated with the development of fibrosis, may be an indicator of unresponsiveness to immunomodulatory treatments.

Gender-Related Effectiveness of Personalized Post-COVID-19 Rehabilitation.

Background: Post-COVID-19 syndrome (PCS) may affect a substantial proportion of patients who have had COVID-19. The rehabilitation program might improve the physical capacity, functioning of the cardiopulmonary system, and mental conditions of these patients. This study aimed to investigate the effectiveness of personalized rehabilitation in patients with PCS according to gender. Methods: Adults who underwent a 6-week personalized PCS rehabilitation program were enrolled in a prospective post-COVID-19 Rehabilitation (PCR-SIRIO 8) study. The initial visit and the final visit included the hand-grip strength test, the bioimpedance analysis of body composition, and the following scales: modified Borg's scale, Modified Fatigue Impact Scale (MFIS), Functioning in Chronic Illness Scale (FCIS), modified Medical Research Council (mMRC) dyspnea scale, and tests: 30 s chair stand test (30 CST), Six-Minute Walk Test (6MWT), Short Physical Performance Battery test (SPPB)e. Results: A total of 90 patients (54% female) underwent the rehabilitation program. Rehabilitation was associated with an increase in skeletal muscle mass (24.11 kg vs. 24.37 kg, p = 0.001) and phase angle (4.89° vs. 5.01°, p = 0.001) and with a reduction in abdominal fat tissue volume (3.03 L vs. 2.85 L, p = 0.01), waist circumference (0.96 m vs. 0.95 m, p = 0.001), and hydration level (83.54% vs. 82.72%, p = 0.001). A decrease in fat tissue volume and an increase in skeletal muscle mass were observed only in females, while an increase in grip strength was noticed selectively in males. Patients' fatigue (modified Borg's scale, MFIS), physical capacity (30 CST, 6MWT), balance (SPPB), dyspnea (mMRC), and functioning (FICS) were significantly improved after the rehabilitation regardless of gender. Conclusions: Personalized rehabilitation improved the body composition, muscle strength, and functioning of patients diagnosed with PCS. The beneficial effect of rehabilitation on body composition, hydration, and phase angle was observed regardless of gender.