Background: Stretching may be viewed as an external/internal force influencing the range of motion of the connective tissue (muscles, tendons and the myotendon unit (MTU)) The magnitude and rate of stretching may potentially induce mechanical responses of the musculoskeletal system, such as increased range of motion (ROM). The degree of the intensity of stretch (low, medium, or high) may be used to optimize recovery from muscle damage via ameliorating inflammation; this is however, a plausible hypothesis that needs to be appropriately investigated. Aims: The present project aimed to investigate: 1) whether intense stretching (IS) causes an acute inflammatory response (study 1), 2) the effects of stretching intensity (low, medium, or high) in the onset of inflammation (study 2), and 3) investigate whether stretching intensity is responsible for aiding in the recovery of the muscle, post muscle damage (study 3). Methods: Studies one and two were randomized crossover trials consisting of 12 and 11 recreational male athletes, respectively. The former investigated whether high intensity stretching can cause an acute inflammatory response, with study two examining the effects of different stretching intensities (30%, 60% and 90%) based on a participant’s perceived maximum range of motion (mROM). Blood for both studies was collected at pre-, post, and 24h post intervention, and analyzed for high sensitivity C-reactive protein (hsCRP) (study 1 and 2), and for interleukin (IL)-1β, IL-6, and tumour necrosis factor (TNF)-α (study 1). In study three, a randomized controlled trial investigated whether stretching intensity (low or high), can influence the recovery from muscle damage. Thirty participants were randomized into three groups, a) low intensity stretching (LiS) (30-40% ROM), b) high intensity stretching (HiS) (70-80% ROM) and c) Control group. All participants performed both eccentric (EPT) and isometric peak torque (IPT) tests prior to a muscle damage protocol (MDP) (baseline). Participants were then assessed for EPT and IPT for three consecutive days post MDP. Soreness levels were recorded immediately post muscle damage and at 24, 48, and 72h, with blood samples collected at pre, 24, 48, and 72h post muscle damage and analyzed for Creatine Kinase (CK) and hsCRP. Results: Study one revealed a significant increase in hsCRP (P = 0.006) when comparing IS to Control condition, also confirmed by the effect size analyses. In study two, low (30% of mROM), and medium (60% of mROM) intensity stretching did not elicit an inflammatory response while a pronounced inflammatory response was observed when comparing 30 to 90 and 60 to 90% mROM. In study three, LiS showed a significant increase in EPT compared to both HiS and Control, and these findings were confirmed by magnitude based inferences analyses (i.e. LiS was associated with a positive effect for both IPT and soreness levels compared to Control and HiS). Blood biomarkers were associated with inconsistent effects compared to Control and HiS for all three-time periods. Conclusions: This thesis provides preliminary results suggesting that increased stretching intensity may be responsible for causing an acute inflammatory response. In addition, it was observed that LiS might be associated with faster recovery from muscle damage with respect to muscle function (EPT and IPT) and soreness levels. More research is needed to investigate these findings further.

Wear particle-induced inflammation leading to periprosthetic osteolysis remains a major cause of hip implant failure. As polyethylene particles from conventional metal-on-polyethylene implants have been associated with these failures, an interest in lower wear metal-on-metal (MM) bearings has emerged. However, the biological effects of nanometer-size chromium oxide particles, predominant type of wear particles produced by MM implants, remain mostly unknown. Therefore, this study aimed to determine the cytotoxicity of nanometer-size Cr2O3 particles on macrophages in vitro, by analyzing their effects on cell mortality and cytokine release and comparing them with those of similarly-sized alumina (Al2O3) particles (known to be relatively bioinert). Results showed that at high concentrations, nanometer-size Cr2O3 particles can be cytotoxic to macrophages, inducing significant decreases in total cell numbers and increases in necrosis. Results also showed that, at high concentrations, the cytotoxicity of Cr2O3 particles was overall higher than that of Al2O3 particles, even though Cr2O3 and Al2O3 are both stable forms of ceramic materials. However, it appeared to be lower than that of previously reported conventional polyethylene and CoCrMo particles. Therefore, chromium oxide particles may not be the main culprit in initiating the inflammatory reaction in MM periprosthetic tissues.

Systemic inflammation is a leading cause of mortality and morbidity in both human and equine intensive care patients. This systemic inflammatory response may be due to insult from bacterial, viral, fungal or parasitic invasion or from trauma or hypoxemia. Local and systemic release of a wide variety of endogenous pro-inflammatory mediators results in activation of the innate immune system in order to resolve the insult. In sepsis this initial appropriate host response becomes amplified and deregulated leading to refractory hypotension and multiple organ dysfunction. The exact incidence of sepsis (SIRS due to bacterial infection) has not been reported in the equine literature (Roy 2004). Since early recognition and treatment of sepsis are associated with improved outcome the search for markers to accurately predict presence of sepsis and likelihood of survival continues. The serum concentration of both procalcitonin and its related molecule CGRP have been documented to increase in humans with SIRS, yet no literature exists as to the production or role of CGRP in equine patients with SIRS. This study showed that equine CGRP was produced in detectable quantities by healthy adult horses and neonatal foals less than two weeks of age using a rat á-CGRP ELISA. The low percentage recovery of CGRP from samples and the high lower limit of detection for the assay prevented establishment of a normal concentration range of CGRP in healthy horses. In both adult horses and foals with documented SIRS, CGRP concentrations were significantly increased at time of presentation to the hospital (p<0.0002, p<0.003 respectively). A trend towards increased serum CGRP concentration was present in anaesethized horses exposed to endotoxin, but this was not statistically significant (p< 0.067). / Master of Science

narmq2@hotmail.com / Objetivo: La inflamación sistémica empeora los trastornos circulatorios en el paciente cirrótico y recientemente el síndrome de respuesta inflamatoria sistémica (SRIS) podría ser un indicador pronóstico en ellos. El objetivo del estudio fue determinar si la presencia de SRIS al ingreso en pacientes cirróticos hospitalizados está asociada a complicaciones o mortalidad. Materiales y métodos: Estudio de cohortes retrospectiva, realizado en el Hospital Nacional Daniel Alcides Carrión. Se admitieron pacientes cirróticos hospitalizados desde julio 2008 hasta diciembre 2010 sin comorbilidades importantes, neoplasia maligna, infección VIH, o estancia fue menor a 72 horas. Se evaluó presencia de SRIS al ingreso y la aparición de complicaciones o muerte después de 72 horas del ingreso. Resultados: Fueron 150 pacientes cirróticos admitidos, se excluyeron 6, tres por supervivencia menor a las 72 horas, uno por neoplasia, uno por insuficiencia cardiaca severa y dos por insuficiencia renal crónica. En total 144 pacientes ingresaron al estudio, 95 (66%) pacientes presentaron SRIS al ingreso. No hubo diferencia significativa en cuanto a edad, sexo, etiología, en ambos grupos. SRIS estuvo asociado a mayores puntajes de MELD y Child-Pugh Turcotte. De los pacientes con SRIS, 41 (43%) se complicaron y 16 (16,8%) fallecieron, mientras que del grupo sin SRIS 5 (10,2%) se complicaron y 2 (4%) fallecieron , ( p <0,0001y p =0,028 respectivamente). Las complicaciones más frecuentes fueron las infecciones y encefalopatía hepática. En el análisis multivariado SRIS estuvo asociado a complicaciones ( p <0,006) mas no a mortalidad ( p <0,276). Conclusiones: SRIS es frecuente en pacientes cirróticos hospitalizados y está asociado a complicaciones intrahospitalarias. / Objective: The systemic inflammation worsens circulatory disorders in cirrhotic patients and recently the systemic inflammatory response syndrome (SIRS) may be a prognostic indicator therein. The aim of the study was to determine whether the presence of SIRS at admission in hospitalized cirrhotic patients is associated with complications or mortality. Materials and methods: A retrospective cohorts study was conducted at the Daniel Alcides Carrion National Hospital. Hospitalized cirrhotic patients admitted from July 2008 to December 2010 without significant comorbidities, malignancy, HIV infection, or stay less than 72 hours were included. Presence of SIRS at admission and the occurrence of complications or death after 72 hours of admission were evaluated. Results: 150 cirrhotic patients were admitted, six were excluded; three for lower survival at 72 hours, one for neoplasia, one for severe heart failure and two for chronic renal failure. One hundred forty four patients were included, 95 (66%) patients had SIRS at admission. There was no significant difference in age, sex, etiology, in both groups. SIRS was associated with higher scores of MELD and Child-Turcotte Pugh. Of the group of patients with SIRS, 41 (43%) had complications and 16 (16.8%) died, while the group without SIRS 5 (10.2%) had complications and two (4%) died ( p <0.0001 and p =0.028 respectively). The most common complications were infections and hepatic encephalopathy. In multivariate analysis SIRS was associated with complications ( p <0.006) but not with mortality ( p <0.276). Conclusions: SIRS is common in hospitalized cirrhotic patients and is associated with in-hospital complications.

Objetivo: La inflamación sistémica empeora los trastornos circulatorios en el paciente cirrótico y recientemente el síndrome de respuesta inflamatoria sistémica (SRIS) podría ser un indicador pronóstico en ellos. El objetivo del estudio fue determinar si la presencia de SRIS al ingreso en pacientes cirróticos hospitalizados está asociada a complicaciones o mortalidad. Materiales y métodos: Estudio de cohortes retrospectiva, realizado en el Hospital Nacional Daniel Alcides Carrión. Se admitieron pacientes cirróticos hospitalizados desde julio 2008 hasta diciembre 2010 sin comorbilidades importantes, neoplasia maligna, infección VIH, o estancia fue menor a 72 horas. Se evaluó presencia de SRIS al ingreso y la aparición de complicaciones o muerte después de 72 horas del ingreso. Resultados: Fueron 150 pacientes cirróticos admitidos, se excluyeron 6, tres por supervivencia menor a las 72 horas, uno por neoplasia, uno por insuficiencia cardiaca severa y dos por insuficiencia renal crónica. En total 144 pacientes ingresaron al estudio, 95 (66%) pacientes presentaron SRIS al ingreso. No hubo diferencia significativa en cuanto a edad, sexo, etiología, en ambos grupos. SRIS estuvo asociado a mayores puntajes de MELD y Child-Pugh Turcotte. De los pacientes con SRIS, 41 (43%) se complicaron y 16 (16,8%) fallecieron, mientras que del grupo sin SRIS 5 (10,2%) se complicaron y 2 (4%) fallecieron, (p<0,0001y p=0,028 respectivamente). Las complicaciones más frecuentes fueron las infecciones y encefalopatía hepática. En el análisis multivariado SRIS estuvo asociado a complicaciones (p<0,006) mas no a mortalidad (p<0,276). Conclusiones: SRIS es frecuente en pacientes cirróticos hospitalizados y está asociado a complicaciones intrahospitalarias. / Objective: The systemic inflammation worsens circulatory disorders in cirrhotic patients and recently the systemic inflammatory response syndrome (SIRS) may be a prognostic indicator therein. The aim of the study was to determine whether the presence of SIRS at admission in hospitalized cirrhotic patients is associated with complications or mortality. Materials and methods: A retrospective cohorts study was conducted at the Daniel Alcides Carrion National Hospital. Hospitalized cirrhotic patients admitted from July 2008 to December 2010 without significant comorbidities, malignancy, HIV infection, or stay less than 72 hours were included. Presence of SIRS at admission and the occurrence of complications or death after 72 hours of admission were evaluated. Results: 150 cirrhotic patients were admitted, six were excluded; three for lower survival at 72 hours, one for neoplasia, one for severe heart failure and two for chronic renal failure. One hundred forty four patients were included, 95 (66%) patients had SIRS at admission. There was no significant difference in age, sex, etiology, in both groups. SIRS was associated with higher scores of MELD and Child-Turcotte Pugh. Of the group of patients with SIRS, 41 (43%) had complications and 16 (16.8%) died, while the group without SIRS 5 (10.2%) had complications and two (4%) died (p<0.0001 and p=0.028 respectively). The most common complications were infections and hepatic encephalopathy. In multivariate analysis SIRS was associated with complications (p<0.006) but not with mortality (p<0.276). Conclusions: SIRS is common in hospitalized cirrhotic patients and is associated with in-hospital complications. Key words: Liver cirrhosis; Systemic inflammatory response syndrome; Complications (source: MeSH NLM).

Mast cells are potent effectors of the inflammatory response, playing an important role in atopy, bacterial immunity, and animal models of arthritis, multiple sclerosis, and heart disease. Hence controlling mast cell numbers and responsiveness is essential for preventing inflammatory disease. This work demonstrated that the cytokine TGF-β1 is a potent inducer of mast cell apoptosis, a finding that was consistent for cultured mouse bone marrow-derived mast cells, peritoneal mast cells, and human mast cells. Cell death appeared to be the result of TGF-mediated repression of IL-3 receptor expression and function, leading to mitochondria1 damage and activation of an apoptotic cascade acting via p53 and caspases. While IL-3 receptor expression was reduced within one day of TGF-βl stimulation, apoptosis required at least 3 days to occur. This delay in onset is postulated to allow for protective mast cell effector functions, protecting the host from infection while preventing the establishment of chronic inflammation. These studies support the theory that TGF- β1 is an inhibitor of mast cell survival. Because of the widespread expression of TGF-β1, this cytokine may be an ideal candidate for control of mast cell homeostasis.

A distrofia muscular de Duchenne (DMD) é uma alteração neuromuscular hereditária e progressiva que afeta humanos do sexo masculino. O modelo canino Golden Retriever Muscular Dystrophy (GRMD) é considerado modelo experimental para estudos de novas propostas terapêuticas e melhor entendimento da fisiopatogênica da DMD. O processo progressivo da distrofia está relacionado com alterações nas populações celulares que compõe o sistema imune dos pacientes, pois devido a ausência da proteína distrofina na membrana sarcoplasmática, o músculo fica mais susceptível à lesões, ocorrendo liberação de citocinas, que recrutam e estimulam células do sistema imune, principalmente macrófagos e linfócitos T. A longo prazo, essa resposta inflamatória contínua e persistente, leva a uma série de reações que culminam com danos cada vez maiores, a ponto de ocorrer um esgotamento de células satélites e fibrose do tecido muscular. Uma das propriedades mais estudadas das células tronco mesenquimais (MSCs) é sua capacidade imunomoduladora, fazendo com que essas células se tornem promissoras na utilização da terapia celular. Neste contexto, esta ferramenta imunomoduladora pode atuar como uma estratégia interessante na manipulação do sistema imune. O estudo proposto foi elaborado com a finalidade de trazer subsídios para viabilização de experimentos de terapia celular na distrofia muscular, por meio do conhecimento sobre a imunomodulação durante o tratamento in vitro, contribuindo para uma possível aplicação terapêutica em humanos. Para tanto, foram estudados dois grupos de cães, um grupo controle (GR; n=5) e um grupo de cães afetados (GRMD; n=9), compostos por machos e fêmeas. O estudo consistiu na avalição da proliferação de linfócitos na presença de MSC em diferentes concentrações, bem como da proliferaçao de linfócitos específicos como o Tauxiliar (CD4+FoxP3-) e Tregulatórios (CD4+FoxP3+) com as MSCs. Adicionalmente, realizamos a dosagem de nitrito com o intuito de quantificar a produção de óxido nítrico (NO) através do cocultivo de macrófagos com as MSCs. Neste estudo foi possível observar que as MSCs estimularam a proliferação significativa de linfócitos T regulatórios. Adicionalmente, essa porcentagem de divisão aumentou em cocultivos que utilizaram maiores concentrações de MSC. Maior concentração de nitrito também foi encontrada no cocultivos de MSC e macrófagos estimulado com LPS. Estas informações geram incrementos no entendimento de como as MSCs podem agir no organismo distrófico e como poderemos explorar essa fonte para promover um retardamento no processo inflamatório e consequentemente melhorar a qualidade de vida do paciente. / The Duchenne muscular dystrophy (DMD) is a progressive hereditary neuromuscular disorder that affects human males. The canine model Golden Retriever Muscular Dystrophy (GRMD) is considered experimental model for studies of new therapies and better understanding of the DMD. The process of progressive dystrophy is related to changes in cell populations that comprise the immune system of patients, because due to the absence of the protein dystrophin in the sarcoplasmic membrane, the muscle is more susceptible to injury, occurring release of cytokines that recruit and stimulate cell immune, mainly macrophages and T lymphocytes in the long term, this continuous and persistent inflammatory response, the system takes a series of reactions that culminate with increasing damage to the point of exhaustion of satellite cells of muscle tissue and fibrosis occur. One of the most studied properties of mesenchymal stem cells (MSCs) is their immunomodulatory capacity, making these cells become promising in the use of cell therapy. In this context, this immunomodulatory can act as an interesting strategy in manipulating the immune system. The proposed study was designed in order to provide support for the feasibility of cell therapy trials in muscular dystrophy, through the knowledge of immunomodulation during treatment in vitro, contributing to a possible therapeutic application in humans. In this purpose, two groups were studied, a group of affected dog (GRMD, n=9) and a control group (GR, n=5 GR). The study consisted of rating of lymphocyte proliferation in the presence of MSCs in different concentrations as well as the proliferation of specific lymphocytes as Thelper (CD4+FoxP3-) and Tregulatory (CD4+FoxP3+) to MSCs. In addition, the dosage of nitrite performed in order to quantify the production of nitric oxide (NO) by coculture with macrophages MSCs. In this study we observed that MSCs stimulated significant proliferation of regulatory T lymphocytes. Additionally, this percentage split increased cocultivos that used higher concentrations of MSC. Highest concentration of nitrite was also found in cocultivos of MSC and macrophages stimulated with LPS. This information generates increments in understanding how MSCs may act in the body dystrophic and how we exploit this source to promote a delay in the inflammatory process and consequently improve the quality of life of patients

O câncer representa desequilíbrio na homeostase do organismo e os mecanismos de defesa para controlar as células tumorais envolvem respostas do sistema imune inato e adaptativo, sendo que a primeira reação do organismo é a inflamação. O objetivo deste estudo foi caracterizar a resposta inflamatória em linhagens de camundongos C57BL/6, CD4KO, CD8KO, RAG e NUDE. Os animais foram tratados com o carcinógeno DMBA e o agente de promoção tumoral TPA. Os animais foram acompanhados e avaliados por 100 dias, após este período a pele tratada foi retirada e processada para análise de citocinas pró- e anti-inflamatórias e enzima mieloperoxidase (MPO). As citocinas pró e anti-inflamatórias e a enzima MPO foram maiores nos animais CD4KO quando comparados aos outros grupos de animais. As linhagens C57BL/6 WT, CD4KO e NUDE foram avaliadas 48 horas após tratamento com DMBA. Os animais CD4KO apresentaram maior número de neutrófilos e citocinas pró-inflamatórias quando comparados aos grupos C57BL/6 WT e NUDE, enquanto que as citocinas anti-inflamatórias não mostraram diferenças nos 3 grupos tratados. Estes resultados sugerem que os linfócitos TCD4 participam do controle da inflamação causada pelo DMBA e TPA. / Cancer represents imbalance in homeostasis and defense mechanisms to control the tumor cells involving the innate and adaptive immune responses, and the first reaction of the body is inflammation. The aim of this study was to characterize the inflammatory response in the following strains: C57BL/6 WT, CD4KO, CD8KO, RAG and NUDE mice. We treated the animals with the carcinogen DMBA as well as with TPA tumor promoting agent. The animals were followed for 100 days and evaluated after this period, the treated skin was removed and processed for analysis of pro-and anti-inflammatory and enzyme myeloperoxidase (MPO). The pro-and anti-inflammatory cytokines and MPO enzyme were higher in animals CD4KO than the other groups of animals. The C57BL/6 WT and CD4KO NUDE lines were evaluated 48 hours after treatment with DMBA. The CD4KO animals had greater numbers of neutrophils and proinflammatory cytokine than the C57BL/6 WT and NUDE mice, while anti-inflammatory cytokines showed no differences in the three treated groups. These results suggest that CD4 + T lymphocytes participate in the control of the induced by DMBA and TPA.

Introdução: Baixas concentrações séricas de hidroxivitamina D (25[OH]D) e o excesso de peso atingiram níveis epidêmicos em todo o mundo. Estudos relatam que concentrações séricas de vitamina D estão associadas às alterações lipídicas, glicolíticas e inflamatórias; e estas alterações são conhecidamente mediadas pela adiposidade. Dessa forma, a vitamina D pode atuar de forma benéfica sobre o perfil metabólico em adolescentes, adultos e idosos. Objetivo: Investigar e descrever as associações entre as concentrações séricas de 25(OH)D e o perfil metabólico, mediadas pela adiposidade em adolescentes, adultos e idosos. Metodologia: Inicialmente, foi utilizada subamostra do Inquérito de Saúde de São Paulo (ISA-Capital), estudo transversal, de base populacional (n=281), para investigar a associação entre as concentrações séricas de vitamina D e marcadores inflamatórios em adultos brasileiros. Posteriormente, foram utilizados dados do estudo Healthy Lifestyle in Europe by Nutrition in Adolescents-(HELENA), estudo multicêntrico transversal da população de adolescentes européia, com o intuito de avaliar as alterações nos marcadores lipídicos e de homeostase da glicose mediados pela deficiência de vitamina D e obesidade. Finalmente, foi analisada a amostra do estudo PHYSMED, um estudo transversal com idosos não institucionalizados para verificar associações entre concentrações séricas de vitamina D, perfil lipídico e composição corporal em idosos espanhóis aparentemente saudáveis. Resultados: Nos adultos, observou-se uma associação negativa entre as concentrações de TNF-alfa e de IL-6 e as concentrações séricas de 25(OH)D em indivíduos com peso normal. Nos adolescentes, as concentrações de 25(OH)D foram associadas de forma independente e positiva com o Quantitative Insulin Sensitivity Check Index-QUICKI (p <0.001) e negativamente associada com o IMC (p <0.05). Também foi observado que o aumento do IMC esteve associado com um aumento de 1.93 vezes maior chance de deficiência de vitamina D (IC de 95 por cento = 1.03 - 3.62; p = 0.040). Em idosos, verificou-se que as concentrações séricas de 25(OH)D foram associadas com o IMC (p = 0.04), a circunferência da cintura (p = 0.004), CT/HDL-c (p = 0.026) e o HDL-c (p = 0.001). Adicionalmente, foi observado que idosos com concentrações de HDL-c <40mg/dl possuíam 1.7 vezes maior chance de apresentarem deficiência de vitamina D em comparação com aqueles que possuíam concentrações de HDL-c >40 mg/dl (95 por cento IC = 1.10 a 2.85; p = 0.017) e o aumento na circunferência da cintura também foi associado com um maior risco de deficiência de vitamina D (95 por cento IC =0.96-1.00; p = 0.04). Conclusão: A composição corporal interage com as concentrações de 25(OH)D modulando a resposta inflamatória, à homeostase da glicose e também o perfil lipídico. Indivíduos sem deficiência de vitamina D apresentam melhor perfil metabólico e também melhor composição, sugerindo que a suficiência de vitamina D pode ter um papel importante nas condições metabólicas mediadas pela adiposidade. / Introduction: Low serum of hydroxyvitamin D (25 [OH] D) and excess weight reached epidemic levels in worldwide. Studies have reported that vitamin D serum concentrations are associated with lipid, glycolytic and inflammatory alterations; and these alterations are known to be mediated by adiposity. Thus, vitamin D may have a benefic action on the metabolic profile in adolescents, adults and elderly. Objective: To investigate and describe the associations between 25(OH)D concentrations and the metabolic profile mediated by adiposity in adolescents, adults and elderly. Methods: Initially, was used a subsample from the Health Survey of São Paulo (HS-SP), cross-sectional, population-based study (n = 281), to investigate the association between vitamin D concentrations and inflammatory biomarkers in Brazilian adults. Later, was used data from Healthy Lifestyle in Europe by Nutrition in Adolescents study - (HELENA), cross-sectional and multicenter study of the European adolescents, in order to evaluate the alterations in lipid markers and glucose homeostasis mediated by vitamin D deficiency and obesity. Finally, was analyzed the sample from PHYSMED study, a cross-sectional study with non-institutionalized elderly, to examine associations between vitamin D concentration, lipid profile and body composition in apparently healthy elderly Spanish. Results: In adults, a negative association was observed between the concentrations of TNF-alpha and IL-6 and serum 25(OH) D in normal weight subjects. In adolescents, the 25(OH) D concentration was associated positive and independently with QUICKI (p <0.001) and negatively associated with BMI (p <0.05). It was also observed that increasing BMI was associated with an increase of 1.93 times odds of vitamin D deficiency (95 per cent CI = 1.3 - 3.62; p = 0.040). In the elderly, it was found that serum of 25(OH) D was associated with the BMI (p = 00:04), waist circumference (p = 0.004), TC/HDL-c ratio (p = 0.026) and HDL -c (p = 0.001). Additionally, it was observed that elderly patients with HDL-c <40mg/dl had 1.7 times odds to develop vitamin D deficiency compared to those had concentrations of HDL-c> 40 mg / dl (95 per cent CI = 1.10 to 2.85 ; p = 0.017) and increases in waist circumference was also associated with an increased risk of vitamin D deficiency (95 per cent CI = 0.96-1.00; P = 0.04). Conclusion: Body composition interacts with 25(OH) D concentrations modulating the inflammatory response, glucose homeostasis and also the lipid profile. Individuals without vitamin D deficiency have better metabolic profile and better body composition, suggesting that vitamin D sufficiency may have an important role in the metabolic conditions mediated by adiposity.

Background and Aims Colorectal cancer is the third most common type of cancer in Sweden, male and female, with 6500 (4500 colonic/2000 rectal) new cases each year. Surgery remains the treatment of choice. Previous studies show that laparoscopic procedure may lead to fewer complications, shorter postoperative stays and a lesser inflammatory response compared to open procedure. The study examines whether laparoscopic surgery of sigmoid cancer differs from open surgery, regarding inflammatory response through analysis of routine measurements. It also investigates differences in peri- and postoperative quality data from Swedish Colorectal Cancer Registry. Material and Methods 307 consecutive patients underwent surgical sigmoidectomy from February 2007- February 2017, from which elective patients with sigmoid cancer were included. Pre-and postoperative CRP and postoperative WBC, Haemoglobin and Creatinine were collected from medical records at the Department of Surgery, Örebro University hospital. Patient related and perioperative variables were collected from SCRCR (e.g. postoperative stay, bleeding, complications). Results 158 patients fulfilled the inclusion criteria. There was a marked increase in CRP postoperative in both laparoscopic (89) and open (69) groups, but no significant difference comparing the groups. There was a significant difference in perioperative bleeding (p&lt;0.05) and length of stay (p&lt;0.05). Conclusion Sigmoidectomy, laparoscopic or open, cause an increase in CRP. No significant difference in inflammatory response was noted between the groups. Patients undergoing laparoscopic, compared to open sigmoidectomy has: less perioperative bleeding, shorter postoperative stay and a longer duration of surgery, like previous studies.