Very low-carbohydrate (VLC) diet with intermittent fasting (IF) have been shown to improve glycemic control and promote weight loss. However, their sustainability beyond 12 months has yet to be shown. This observational study aimed to assess sustainable weight loss and improvement in metabolic profile with such strategy in a self-motivated cohort. Subjects were recruited from a social media-based group who had to be on VLC±IF. Participants completed a questionnaire through on online survey tool. Participants voluntarily provided laboratory data pre-and post-lifestyle intervention. 63 patients participated in the study. Mean length on the diet was 35.8 months. Mean weight loss was 16.1 kg (|Z|-value 4.13, p<.0001). 53/63 (84.1%) respondents practiced IF. 18/63 (28.6%) reported fasting for 16 hours and eat within an 8-hour window whereas 15/63 (23.8%) reported fasting for 18 hours and eat within a 6-hour window. Mean carbohydrate intake was 10%. Change in mean glucose level was from 121.6 mg/dl to 90.4 mg/dl (|Z|-value 3.08, p 0.0034) and hemoglobin A1c from 6.87% to 5.2% (|Z|-value 3.96, p .0002). Triglycerides level showed reduction from 159.4 mg/dl to 98.4 mg/dl (|Z|-value 3.39, p 0.0012). HDL levels increased from 50.2 mg/dl to 66.9 mg/dl (|Z|-value 3.46, p<0.001) whereas total cholesterol level and LDL level increased from 206.3 mg/dl to 236 mg/dl (|Z|-value 1.94, p 0.0561) and from 138.4 mg/dl to 156.4 mg/dl (|Z|-value 1.68, p 0.0977) respectively. Participation of social media-based support group provides a unique opportunity to study the effects of different dietary and fasting approaches in real-world situations and is more likely to indicate the durability of such approaches. Although observational in nature with the caveat of self-reporting, the results are promising and call for larger, randomized trials.

Our data confirmed that SF ≥1000 increases the risk of infection, moreover fungal infection in transplant recipients. As SQUID values correlate well with SF, we could show that SF is indeed a good surrogate parameter for iron overload when measured shortly before SCT. Prospective trials are needed to investigate the effect of iron chelation before or during SCT on transplant outcome.

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Objectives: Peripheral arterial occlusive disease (PAOD) and periodontitis are common chronic diseases, which together affect almost 1 billion people worldwide. There is growing evidence suggesting a relationship between chronic inflammatory conditions such as periodontitis and PAOD. This study aims to determine an association between both entities using high quality research data and multiple phenotypes derived from an epidemiological cohort study. Design: This population-based cross-sectional cohort study included data from 3271 participants aged between 45 and 74 years enrolled in the Hamburg City Health Study (NCT03934957). Material & Methods: An ankle-brachial-index below 0.9, color-coded ultrasound of the lower extremity arteries, and survey data was used to identify participants with either asymptomatic or symptomatic PAOD. Periodontitis data was collected at six sites per tooth and included the probing depth, gingival recession, clinical attachment loss, and bleeding on probing index. Multivariate analyses using logistic regression models were adjusted for variables including age, sex, smoking, education, diabetes, and hypertension. Results: The baseline characteristics differed widely between participants neither affected by periodontitis nor PAOD vs. the group where both PAOD and severe periodontitis were identified. A higher rate of males, higher age, lower education level, smoking, diabetes, and cardiovascular disease was observed in the group affected by both diseases. After adjusting, presence of severe periodontitis (odds ratio 1.265; 97.5% CI 1.006–1.591; p = 0.045) was independently associated with PAOD. Conclusion: In this cross-sectional analysis of a prospective cohort study, an independent association between periodontitis and PAOD was revealed. The results of the current study emphasize a potential for preventive medicine in an extremely sensitive target population. Future studies should determine the underlying factors modifying the relationship between both diseases.

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Recently developed prognostic models for follicular lymphoma have proven useful in predicting overall survival (OS), but most have used data from multiple centers. Our goal was to look at prognostic factors within a single institution.We conducted a retrospective study on 77 newly diagnosed patients with follicular lymphoma, focussing on clinical characteristics, symptom duration before diagnosis, pathologic findings, including grade, laboratory data, imaging studies at initial presentation and management. The study population was 53% male. Ages ranged from 25 to 87 years (median 51). By Ann Arbor classification 4% were stage I, 8% stage II, 18% stage III and 69% stage IV. Initial therapy was deferred in 39%. The remaining patients received stageappropriate therapy. Survival was measured from time of diagnosis to death. Prognostic factors at initial diagnosis that were statistically significant in univariate log-rank comparisons of Kaplan-Meier survival curves were used to build a multivariate proportional hazard regression model of OS. Median OS for these patients was 10.3 years. OS differed only with high (>12 g/dl) versus low (<12 g/dl) hemoglobin (p=0.001) and in younger (<60 years) versus older (>60 years) patients (p=0.05), as indicated by univariate log-rank tests. Both hemoglobin and age were also significant in a multivariate proportional hazards analysis. Low hemoglobin and increased age were independent predictors of lower OS with hazard ratios of 6.6 (95% CI, 2.2-20.1) and 3.7 (95% CI, 1.2-11.7), respectively. Median survival for older patients who also had anemia was only 3.1 years. A test for interaction between age and hemoglobin was negative (p=0.35). The estimated hazard ratio for an older individual with low hemoglobin was 24.7 (95% CI, 4.0-153.3). To assess the proportional hazards assumption we tested for an interaction between time and both age (p=0.92) and hemoglobin (p=0.66) and found no evidence against proportionality. A hemoglobin <12 g/dl and age >60 years at diagnosis are significant predictors of worse OS.

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