Management of diabetes mellitus in individuals with chronic kidney disease: therapeutic perspectives and glycemic control

The purpose of this study was to evaluate the therapeutic options for diabetes treatment and their potential side effects, in addition to analyzing the risks and benefits of tight glycemic control in patients with diabetic kidney disease. For this review, a search was performed using several pre-defined keyword combinations and their equivalents: “diabetes kidney disease” and “renal failure” in combination with “diabetes treatment” and “oral antidiabetic drugs” or “oral hypoglycemic agents.” The search was performed in PubMed, Endocrine Abstracts and the Cochrane Library from January 1980 up to January 2015. Diabetes treatment in patients with diabetic kidney disease is challenging, in part because of progression of renal failure-related changes in insulin signaling, glucose transport and metabolism, favoring both hyperglycemic peaks and hypoglycemia. Additionally, the decline in renal function impairs the clearance and metabolism of antidiabetic agents and insulin, frequently requiring reassessment of prescriptions. The management of hyperglycemia in patients with diabetic kidney disease is even more difficult, requiring adjustment of antidiabetic agents and insulin doses. The health team responsible for the follow-up of these patients should be vigilant and prepared to make such changes; however, unfortunately, there are few guidelines addressing the nuances of the management of this specific population

Different proportion of root cutting and shoot pruning influence the growth of citronella plants

Environment concern, sustainable products demand, and natural components conscious are currently global movement factors. Related to the global movement factors, citronella grass (Cymbopogon nardus L.) is being widely used in folk medicine, and has insect repellent activity, fungal and bactericidal action. Its essential oil has high content of citronellal, citronellol, geraniol. The essential oil is mostly extracted from leaves which turns this plant with high commercial demand. However, to obtain the best therapeutic quality and productivity of medicinal plants, which culminates in greater quantity and quality of the active compounds, the proper management of the crop is fundamental, as several factors can interfere during its growth and development. Thus, we analyzed the growth of citronella plants submitted to different levels of shoot and root cuts. Five different proportions of root pruning (0, 25, 50, 75, 100%), after 145 days of seedling planting and four cuttings in the shoots: blunt; a cut at 145 DAP (days after planting) along with the root cut; a cut at 228 DAP; and cuts at 145 and 228 DAP (two cuts). Four harvesting for dry matter accumulation and photoassimilate partition data were performed. The treatment with 100% root cut, but without leaf cut, increased the total dry mass accumulation of the plant in relation to the other treatments, for the last analysis period, demonstrating a recovery. Thus, the application of two leaf cuts or no leaf cutting within the 100% root cut treatment for leaf dry mass accumulation is more effective when compared to the blunt root treatment

HASTE INTRAMEDULAR DE POLIPROPILENO, COMBINADA OU NÃO A BIOMATERIAIS, NO TRATAMENTO DE FRATURAS INDUZIDAS NO ÚMERO DE POMBOS

O trabalho teve por objetivo avaliar a utilização da haste intramedular de polipropileno, combinada ou não a biomateriais de origem bovina, no tratamento de fraturas transversas induzidas no terço médio do úmero direito de pombos-domésticos. No grupo I (n=7), a fratura foi estabilizada por meio de haste intramedular de polipropileno aplicada em ambos os fragmentos da fratura, sem ultrapassar as articulações. No grupo II (n=7) utilizou-se a mesma fixação, porém foi aplicado junto ao foco de fratura uma mistura de biomateriais, constituída de proteínas morfogenéticas do osso e aglutinante de colágeno liofilizado. Em ambos os grupos, a asa foi imobilizada junto ao corpo com bandagem em forma de 8 por um período de 30 dias. Com seis semanas de pós-operatório, cinco fraturas do grupo I e quatro do grupo II estavam totalmente consolidadas. Foram observadas uma não consolidação hipertrófica (grupo I) e duas não consolidações com deslocamento do eixo ósseo (grupo II). Exceto as três aves que apresentaram complicações nas fraturas, as demais recuperaram a capacidade de vôo. Foi possível concluir que a haste intramedular de polipropileno foi um método de imobilização de eficácia limitada e os biomateriais utilizados não estimularam a consolidação das fraturas. Use of polypropylene intramedullary rod alone or combined with biomaterials for treatment of induced humeral transverse fractures in pigeons Abstract The aim of this study was to evaluate a polypropylene intramedullary rod alone or combined with biomaterials from bovine origin for the treatment of transverse fractures induced in the midshaft of right humerus in pigeons. In group I (n=7) the fracture was immobilized using a polypropylene intramedullary rod inserted into both fractured extremities without entering the joints. The same device was used in group II (n=7). Additionally, the fractured site in group II animals received a mixture of biomaterials composed by bone morphogenetic proteins and lyophilized collagen. In both groups a cast was applied to the affected wing, which was immobilized with a figure-of-8 bandage applied to the body and wing during 30 days. Complete healing was observed after six weeks of surgery in five and four animals from groups I and II, respectively. Observed complications included one hypertrophic nonunion (group I) and two nonunion with bone shaft dislocation (group II). Except for the three pigeons that showed postoperative complications, the remaining animals recovered the ability of flight. It was possible to conclude that the polypropylene intramedullary rod is a limited method of immobilization and the biomaterials used in this study did not stimulate fracture healing

Protective effect of tomato-oleoresin supplementation on oxidative injury recoveries cardiac function by improving β-adrenergic response in a diet-obesity induced model

The system redox imbalance is one of the pathways related to obesity-related cardiac dysfunction. Lycopene is considered one of the best antioxidants. The aim of this study was to test if the tomato-oleoresin would be able to recovery cardiac function by improving \u3b2-adrenergic response due its antioxidant effect. A total of 40 animals were randomly divided into two experimental groups to receive either the control diet (Control, n = 20) or a high sugar-fat diet (HSF, n = 20) for 20 weeks. Once cardiac dysfunction was detected by echocardiogram in the HSF group, animals were re- divided to begin the treatment with Tomato-oleoresin or vehicle, performing four groups: Control (n = 6); (Control + Ly, n = 6); HSF (n = 6) and (HSF + Ly, n = 6). Tomato oleoresin (10 mg lycopene/kg body weight (BW) per day) was given orally every morning for a 10-week period. The analysis included nutritional and plasma biochemical parameters, systolic blood pressure, oxidative parameters in plasma, heart, and cardiac analyses in vivo and in vitro. A comparison among the groups was performed by two-way analysis of variance (ANOVA). Results: The HSF diet was able to induce obesity, insulin-resistance, cardiac dysfunction, and oxidative damage. However, the tomato-oleoresin supplementation improved insulin-resistance, cardiac remodeling, and dysfunction by improving the \u3b2-adrenergic response. It is possible to conclude that tomato-oleoresin is able to reduce the oxidative damage by improving the system\u2019s \u3b2-adrenergic response, thus recovering cardiac function

Antiretroviral therapy initiation alters the redox system of asymptomatic HIV-Infected individuals

Background. The combination antiretroviral therapy (cART) increases the oxidative stress in HIV-infected people, which in turn favors the onset and aggravation of non-AIDS comorbidities, a common situation affecting these individuals. We aimed to evaluate the influence of cART initiation on oxidative stress parameters. This is a longitudinal study including 30 asymptomatic patients divided according to their CD4+ T cell count (G1: 500 cell/mL) before (M0) and after (M1) cART initiation. We analyzed total antioxidant capacity (TAC), fat-soluble vitamins, malondialdehyde, 8-isoprostane, and DNA damage. Results. Results showed a decrease in TAC, retinol, \u3b1-tocopherol, and some carotenoids, in addition to a significant increase in DNA damage at M1. These changes were more evident in G2 subjects. Moreover, there was a significant 8-isoprostane increase at M1 in individuals belonging to G1. Conclusion. The results indicate that cART interfered in the redox system, mainly by reducing the antioxidant defenses. In addition, patients who had CD4+ T counts higher than 500 cells/mm3 showed more susceptibility to genotoxicity, while patients with less CD4+ T counts displayed more damage triggered by lipoperoxidation. Considering the early beginning of cART, its chronic use, and its capacity to alter the redox status, further long-term studies on larger cohorts are needed to define the best time to initiate therapy and to investigate new strategies to delay the development of non-AIDS diseases

The initial months of antiretroviral therapy and its influence on AGEs, HMGB1, and sRAGE levels in asymptomatic HIV-infected individuals

The development of the typical comorbidities of aging which currently affects people living with HIV/AIDS (PLWHA) can be partially ascribed to the persistent immune activation and chronic inflammation characterizing these individuals. The aim of this study was to analyze the effect exerted by combined antiretroviral therapy (cART) administration on plasma levels of HMGB1 (high mobility group box protein-1), AGEs (advanced glycation end products), their soluble receptor sRAGE, cytokines, C-reactive protein (CRP), and some metabolic markers in asymptomatic PLWHA. Analyses were performed longitudinally in 30 PLWHA, before and about 6\u201312 months after cART initiation. We observed that lower levels of AGEs in post-cART group were accompanied by an increase of CRP and triglyceride levels already in the early months of therapy. Because of the current ever-earlier recommendations to start cART and its prolonged use, these and other markers should be investigated in order to monitor and postpone the appearance of non-AIDS comorbidities in PLWHA

Testing spatial noncommutativiy via the Aharonov-Bohm effect

The possibility of detecting noncommutative space relics is analyzed using the Aharonov-Bohm effect. We show that, if space is noncommutative, the holonomy receives non-trivial kinematical corrections that will produce a diffraction pattern even when the magnetic flux is quantized. The scattering problem is also formulated, and the differential cross section is calculated. Our results can be extrapolated to high energy physics and the bound $\theta \sim [ 10 {TeV}]^{-2}$ is found. If this bound holds, then noncommutative effects could be explored in scattering experiments measuring differential cross sections for small angles. The bound state Aharonov- Bohm effect is also discussed.Comment: 16 pp, Revtex 4, 2 fig, new references added. To appear in PR

Typification and authorship of Drosera intermedia (Droseraceae)

Drosera intermedia is lectotypified with the herbarium specimen on which the type drawing in the 1798 protologue was based. The collection history of the specimen, the history of the botanical drawing as original material, and the correct nomenclatural author and publication date of the name are presented based on historical notes and literature. Additionally, the global distribution of the species is given, including the first record from Africa

Search for a W' boson decaying to a bottom quark and a top quark in pp collisions at sqrt(s) = 7 TeV

Results are presented from a search for a W' boson using a dataset corresponding to 5.0 inverse femtobarns of integrated luminosity collected during 2011 by the CMS experiment at the LHC in pp collisions at sqrt(s)=7 TeV. The W' boson is modeled as a heavy W boson, but different scenarios for the couplings to fermions are considered, involving both left-handed and right-handed chiral projections of the fermions, as well as an arbitrary mixture of the two. The search is performed in the decay channel W' to t b, leading to a final state signature with a single lepton (e, mu), missing transverse energy, and jets, at least one of which is tagged as a b-jet. A W' boson that couples to fermions with the same coupling constant as the W, but to the right-handed rather than left-handed chiral projections, is excluded for masses below 1.85 TeV at the 95% confidence level. For the first time using LHC data, constraints on the W' gauge coupling for a set of left- and right-handed coupling combinations have been placed. These results represent a significant improvement over previously published limits.Comment: Submitted to Physics Letters B. Replaced with version publishe