Metabolic and Endocrine correlates of cognitive function in healthy young women

Obesity has been associated with cognitive decline in longitudinal studies of older individuals. We hypothesized that the cognitive sequelae of obesity may be detectable in the reproductive years. In addition, we explored the hypothesis that these associations may be mediated by the hormonal milieu. In this study of 49 young healthy lean and overweight women aged 20–45, we investigated the association between performance on a battery of cognitive tests, body composition parameters (BMI, total fat, abdominal (visceral, subcutaneous and total) adipose tissue, and muscle), and hormone levels (insulin, adiponectin, leptin, IGF-1, estrogen, testosterone, and vitamin D). We found a significant negative association between both visceral adiposity and muscle, and performance in the domain of verbal learning and memory, after controlling for age and education. Other body composition parameters showed similar trends (0.05<p<0.10). Additionally, the degree of insulin resistance was negatively associated with executive function domain. None of the associations between the other hormones examined (adipokines, IGF-1, gonadal hormones and vitamin D) and cognitive function were significant. These preliminary findings suggest a possible association between obesity and cognitive function in healthy young women of reproductive age. More research is warranted into the potential modulatory effect of insulin resistance on this association

Which differences do elderly patients present in single-stage treatment for cholecysto-choledocholithiasis?

AbstractPatients with symptomatic gallstones present common bile duct stones in approximately 10% of cases. It is possible to resolve both gallbladder and bile duct stones with a single procedure. The aim of this study is to determine the effectiveness of a single stage procedure for gallbladder and bile duct stones in the elderly patients and to expose the differences between the various techniques. From January 2008 to December 2013, we treated 1540 patients with gallbladder stones. In 152 cases, we also found bile duct stones. 150 of these were treated in a single stage procedure. We divided our patients into 2 groups: Group A was younger than 65 (104 patients); Group B was 65 or older (46 patients). We retrospectively compared sex, ASA score, conversion rate, success rate, post-operative complications, hospital stay, and treatment method. We had no intra-operative mortality. 1 patient in Group B, heart condition (ASA 4), died with multiple organ failure (MOF) 10 days after his operation. ASA score: 3.5 ± 0.5 in A vs 2 ± 0.9 in B (P 0.001), post-operative complications 6% in A vs 18.1% in B (P 0.0325) and hospital stay 4.1 ± 2.3 in A vs 9.5 ± 5.5 in B (P 0.0001) were significantly higher in Group B. No differences were found in term of success rate: 94% in A vs 90% in B (P 0.4944). The procedure used to obtain the clearance of the bile duct showed a different success rate across the two groups: for the patients under 65 years old, trans-cystic clearance (TC-CBDE) was successful in 90% of cases, and only 51% for those older than 65, where we had to recall 49% for laparo-endoscopic rendez-vous (RV-IOERC) (P 0.0014). In conclusion, single stage treatment is safe and effective also to elderly patients. The methods used in patients being younger than 65 years old is what appeared to be significantly different

Genome-wide analyses of Liberibacter species provides insights into evolution, phylogenetic relationships, and virulence factors.

'Candidatus Liberibacter' species are insect-transmitted, phloem-limited α-Proteobacteria in the order of Rhizobiales. The citrus industry is facing significant challenges due to huanglongbing, associated with infection from 'Candidatus Liberibacter asiaticus' (Las). In order to gain greater insight into 'Ca. Liberibacter' biology and genetic diversity, we have performed genome sequencing and comparative analyses of diverse 'Ca. Liberibacter' species, including those that can infect citrus. Our phylogenetic analysis differentiates 'Ca. Liberibacter' species and Rhizobiales in separate clades and suggests stepwise evolution from a common ancestor splitting first into nonpathogenic Liberibacter crescens followed by diversification of pathogenic 'Ca. Liberibacter' species. Further analysis of Las genomes from different geographical locations revealed diversity among isolates from the United States. Our phylogenetic study also indicates multiple Las introduction events in California and spread of the pathogen from Florida to Texas. Texan Las isolates were closely related, while Florida and Asian isolates exhibited the most genetic variation. We have identified conserved Sec translocon (SEC)-dependent effectors likely involved in bacterial survival and virulence of Las and analysed their expression in their plant host (citrus) and insect vector (Diaphorina citri). Individual SEC-dependent effectors exhibited differential expression patterns between host and vector, indicating that Las uses its effector repertoire to differentially modulate diverse organisms. Collectively, this work provides insights into the evolution of 'Ca. Liberibacter' species, the introduction of Las in the United States and identifies promising Las targets for disease management

Studio comparativo tra tecnica tradizionale, Ligasure Precise® ed Harmonic Focus™ nella tiroidectomia totale

Lo scopo di questo studio è stato quello di comparare i risultati ottenuti con la tecnica tradizionale, l’utilizzo della pinza bipolare (Ligasure Precise®), e la forbice curva (Harmonic Focus™) in corso di tiroidectomia totale. Sono stati arruolati 93 pazienti che, dopo aver espresso il proprio consenso informato, sono stati inseriti, in maniera randomizzata, nei tre gruppi di studio: 31 pz al gruppo L (Ligasure Precise®); 31 pz al gruppo F (Harmonic Focus™); 31 pz al gruppo C (tecnica chirurgica classica mediante legature). Sono stati analizzati e confrontati età, calcemia preoperatoria, durata dell’intervento, degenza, peso della ghiandola asportata, patologia tiroidea di base, comparsa di emorragia post-operatoria, calcemia post-operatoria al primo e secondo giorno e lesioni del nervo ricorrente. I tre gruppi non presentano differenze statisticamente significative rispetto all’età, al sesso ed alla patologia tiroidea di base. Non abbiamo osservato emorragie post-operatorie. L’incidenza totale di ipocalcemia (inferiore a 8 mg/dl) è stata del 38,9% (36 pz) e l’ospedalizzazione media è stata di 2,3 giorni in assenza di differenze significative tra i tre gruppi. Solo un paziente (gruppo F) ha presentato una paralisi temporanea del nervo ricorrente. La durata media dell’intervento (minuti) si è significativamente ridotta del 15% nel gruppo F (62,7±14,1) rispetto al gruppo C (72,7±13,6; Kruskal-Wallis test: p<0.05). Entrambi i nuovi devices risultano sicuri ed efficaci. L’unico vantaggio osservato è stata una riduzione significativa del tempo operatorio con l’utilizzo dell’ Harmonic Focus™ rispetto alle altre tecniche