Interactions of leptospira with environmental bacteria from surface water

Leptospires can persist for months in nutrient-poor aqueous environments prior to transmission to a mammalian host. Interactions with environmental bacteria and biofilm formation are possible mechanisms of persistence of leptospires in the environment. Bacteria isolated from rivers in the Ecuadorian rainforest were tested for their ability to support leptospiral viability. We found that co-culture with Sphingomonas spp., but not Flavobacterium spp. or Delftia spp., enabled survival of L. biflexa and L. meyeri for up to a year in distilled water. We also found that L. interrogans biofilms formed in distilled water contained viable organisms that rapidly dispersed into the planktonic phase in the presence of nutrients in serum or EMJH medium. These data inform our understanding of leptospiral survival strategies that enable long-term persistence in nutrient-poor conditions yet allow rapid mobilization when nutrients become available.     

Obesity‐related hypertension: Pathogenesis,cardiovascular risk,and treatment—A position paper of the The Obesity Society and the American Society of Hypertension

In light of the worldwide epidemic of obesity, and in recognition of hypertension as a major factor in the cardiovascular morbidity and mortality associated with obesity, The Obesity Society and The American Society of Hypertension agreed to jointly sponsor a position paper on obesity‐related hypertension to be published jointly in the journals of each society. The purpose is to inform the members of both societies, as well as practicing clinicians, with a timely review of the association between obesity and high blood pressure, the risk that this association entails, and the options for rational, evidenced‐based treatment. The position paper is divided into six sections plus a summary as follows: pathophysiology, epidemiology and cardiovascular risk, the metabolic syndrome, lifestyle management in prevention and treatment, pharmacologic treatment of hypertension in the obese, and the medical and surgical treatment of obesity in obese hypertensive patients. Obesity (2012)     

Effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction: a systematic review and meta-analysis of randomized controlled trials

Background:

Evidence from controlled trials encourages the intake of dietary pulses (beans, chickpeas, lentils and peas) as a method of improving dyslipidemia, but heart health guidelines have stopped short of ascribing specific benefits to this type of intervention or have graded the beneficial evidence as low. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction.

Methods:

We searched electronic databases and bibliographies of selected trials for relevant articles published through Feb. 5, 2014. We included RCTs of at least 3 weeks’ duration that compared a diet emphasizing dietary pulse intake with an isocaloric diet that did not include dietary pulses. The lipid targets investigated were low-density lipoprotein (LDL) cholesterol, apolipoprotein B and non–high-density lipoprotein (non-HDL) cholesterol. We pooled data using a random-effects model.

Results:

We identified 26 RCTs (n = 1037) that satisfied the inclusion criteria. Diets emphasizing dietary pulse intake at a median dose of 130 g/d (about 1 serving daily) significantly lowered LDL cholesterol levels compared with the control diets (mean difference −0.17 mmol/L, 95% confidence interval −0.25 to −0.09 mmol/L). Treatment effects on apolipoprotein B and non-HDL cholesterol were not observed.

Interpretation:

Our findings suggest that dietary pulse intake significantly reduces LDL cholesterol levels. Trials of longer duration and higher quality are needed to verify these results. Trial registration: ClinicalTrials.gov, no. {"type":"clinical-trial","attrs":{"text":"NCT01594567","term_id":"NCT01594567"}}NCT01594567.Abnormal blood concentrations of lipids are one of the most important modifiable risk factors for cardiovascular disease. Although statins are effective in reducing low-density lipoprotein (LDL) cholesterol levels, major health organizations have maintained that the initial and essential approach to the prevention and management of cardiovascular disease is to modify dietary and lifestyle patterns.^1–4Dietary non–oil-seed pulses (beans, chickpeas, lentils and peas) are foods that have received particular attention for their ability to reduce the risk of cardiovascular disease. Consumption of dietary pulses was associated with a reduction in cardiovascular disease in a large observational study⁵ and with improvements in LDL cholesterol levels in small trials.^6–8 Although most guidelines on the prevention of major chronic diseases encourage the consumption of dietary pulses as part of a healthy strategy,^2,3,9–13 none has included recommendations based on the direct benefits of lowering lipid concentrations or reducing the risk of cardiovascular disease. In all cases, the evidence on which recommendations have been based was assigned a low grade,^2,3,9–13 and dyslipidemia guidelines do not address dietary pulse intake directly.^1,4To improve the evidence on which dietary guidelines are based, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) of the effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction. The lipid targets were LDL cholesterol, apolipoprotein B and non–high-density lipoprotein (non-HDL) cholesterol.     

Effect of Tree Nuts on Glycemic Control in Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Dietary Trials

Background

Tree nut consumption has been associated with reduced diabetes risk, however, results from randomized trials on glycemic control have been inconsistent.

Objective

To provide better evidence for diabetes guidelines development, we conducted a systematic review and meta-analysis of randomized controlled trials to assess the effects of tree nuts on markers of glycemic control in individuals with diabetes.

Data Sources

MEDLINE, EMBASE, CINAHL, and Cochrane databases through 6 April 2014.

Study Selection

Randomized controlled trials ≥3 weeks conducted in individuals with diabetes that compare the effect of diets emphasizing tree nuts to isocaloric diets without tree nuts on HbA1c, fasting glucose, fasting insulin, and HOMA-IR.

Data Extraction and Synthesis

Two independent reviewer’s extracted relevant data and assessed study quality and risk of bias. Data were pooled by the generic inverse variance method and expressed as mean differences (MD) with 95% CI’s. Heterogeneity was assessed (Cochran Q-statistic) and quantified (I²).

Results

Twelve trials (n = 450) were included. Diets emphasizing tree nuts at a median dose of 56 g/d significantly lowered HbA1c (MD = −0.07% [95% CI:−0.10, −0.03%]; P = 0.0003) and fasting glucose (MD = −0.15 mmol/L [95% CI: −0.27, −0.02 mmol/L]; P = 0.03) compared with control diets. No significant treatment effects were observed for fasting insulin and HOMA-IR, however the direction of effect favoured tree nuts.

Limitations

Majority of trials were of short duration and poor quality.

Conclusions

Pooled analyses show that tree nuts improve glycemic control in individuals with type 2 diabetes, supporting their inclusion in a healthy diet. Owing to the uncertainties in our analyses there is a need for longer, higher quality trials with a focus on using nuts to displace high-glycemic index carbohydrates.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01630980","term_id":"NCT01630980"}}NCT01630980     

Regional Integration and Household Resilience: Infrastructure Connectivity and Livelihood Diversity in the Southwestern Amazon

The Inter-Oceanic Highway is among the first wave of large infrastructure projects under the auspices of the Initiative for the Integration of Regional Infrastructure in South America, which proposes regional integration as a means of economic development. Such projects have reignited debates over infrastructure impacts, which in many ways center on the ramifications for natural resource management. We pursue an analysis of the implications of highway paving for local livelihoods by focusing on the effects of market connectivity on livelihood diversity. Given that infrastructure brings shocks to affected regions, we argue that livelihood diversity is usefully interpreted in terms of household resilience to such shocks. We draw on rural household surveys from the tri-national frontier where Bolivia, Brazil and Peru meet in the southwestern Amazon, where the Inter-Oceanic Highway has recently been paved. The findings show that households more connected to markets in terms of travel time and road paving have less diverse livelihoods. This confirms concerns about regional integration and rural household vulnerability.     

Physiological basis for effect of physical conditioning on chronic ethanol-induced hypertension in a rat model

The study aim was to investigate the interaction of physical conditioning and chronic ethanol ingestion on blood pressure (BP), heart rate (HR), nitric oxide (NO) and oxidants/antioxidants balance in the plasma of rats. Male Fisher rats were divided into four groups of seven animals each and treated as follows: (1) Control (5% sucrose, orally) daily for 12 weeks; (2) ethanol (4 g kg⁻¹, orally) daily for 12 weeks; (3) exercise training on treadmill plus sucrose daily for 12 weeks and (4) exercise training on treadmill followed by ethanol (4 g kg⁻¹, orally) daily for 12 weeks. The body weight, BP and HR were recorded every week. The animals were sacrificed under ether anesthesia after 12 weeks, blood collected in heparinzed vials, plasma isolated and analyzed. The results show that exercise training significantly lowered the weight gain 6–12 weeks in ethanol treated rats compared to ethanol alone or control rats. The mean arterial BP was significantly elevated 6–12 weeks after ethanol ingestion without significant alterations in HR. Exercise training lowered the BP close to the normal control values in ethanol fed rats. Ethanol significantly decreased the plasma NO levels, reduced to oxidized glutathione ratio (GSH/GSSG) and antioxidant enzymes-superoxide dismutase (CuZn-SOD, and Mn-SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) activities while plasma NADPH oxidase activity and malondialdehyde (MDA) levels were significantly elevated compared to control. Exercise training significantly restored the depletion of plasma NO levels, GSH/GSSG ratio, and antioxidant enzyme activities and normalized the MDA levels and NADPH oxidase activity in the plasma of ethanol treated rats. The study concluded that physical conditioning attenuates the chronic ethanol-induced hypertension by augmenting the NO bioavailability and reducing the oxidative stress response in the plasma of rats.