Diagnostic value of minor salivary glands biopsy for the detection of Lewy pathology

The recent demonstration of the presence of Lewy pathology in the submandibular glands of Parkinson\u27s disease (PD) patients prompted us to evaluate the diagnostic performance of minor salivary gland biopsy for PD. Minor salivary glands were examined for Lewy pathology using phosphorylated alpha-synuclein antibody in 16 patients with clinically diagnosed PD and 11 control subjects with other neurological disorders. Abnormal accumulation of alpha-synuclein was found in 3 out of 16 PD patients. Two control subjects exhibited weak phosphorylated alpha-synuclein immunoreactivity. Our results do not support the use of minor salivary glands biopsy for the detection of Lewy pathology in living subjects

The IASI Water Deficit Index to Monitor Vegetation Stress and Early Drying in Summer Heatwaves: An Application to Southern Italy

The boreal hemisphere has been experiencing increasing extreme hot and dry conditions over the past few decades, consistent with anthropogenic climate change. The continental extension of this phenomenon calls for tools and techniques capable of monitoring the global to regional scales. In this context, satellite data can satisfy the need for global coverage. The main objective we have addressed in the present paper is the capability of infrared satellite observations to monitor the vegetation stress due to increasing drought and heatwaves in summer. We have designed and implemented a new water deficit index (wdi) that exploits satellite observations in the infrared to retrieve humidity, air temperature, and surface temperature simultaneously. These three parameters are combined to provide the water deficit index. The index has been developed based on the Infrared Atmospheric Sounder Interferometer or IASI, which covers the infrared spectral range 645 to 2760 cm−1 with a sampling of 0.25 cm−1. The index has been used to study the 2017 heatwave, which hit continental Europe from May to October. In particular, we have examined southern Italy, where Mediterranean forests suffer from climate change. We have computed the index’s time series and show that it can be used to indicate the atmospheric background conditions associated with meteorological drought. We have also found a good agreement with soil moisture, which suggests that the persistence of an anomalously high water deficit index was an essential driver of the rapid development and evolution of the exceptionally severe 2017 droughts

Determinants of the Increase in Fasting Plasma Ketone Concentration during SGLT2 Inhibition in NGT, IFG and T2DM Patients

To examine metabolic factors that influence ketone production after sodium-glucose cotransport inhibitor (SGLT2) administration RESEARCH DESIGN AND METHODS: Fasting plasma glucose, insulin, glucagon, free fatty acid and ketone concentrations were measured in 15 type 2 diabetes mellitus (T2DM) and 16 non-diabetic subjects before and at 1 and 14 days after treatment with empagliflozin

NGC 3576 and NGC 3603: Two Luminous Southern HII Regions Observed at High Resolution with the Australia Telescope Compact Array

NGC 3576 (G291.28-0.71; l=291.3o, b=-0.7o) and NGC 3603 (G291.58-0.43; l=291.6o, b=-0.5o) are optically visible, luminous HII regions located at distances of 3.0 kpc and 6.1 kpc, respectively. We present 3.4 cm Australian Telescope Compact Array (ATCA) observations of these two sources in the continuum and the H90a, He90a, C90a and H113b recombination lines with an angular resolution of 7" and a velocity resolution of 2.6 km/s. All four recombination lines are detected in the integrated profiles of the two sources. Broad radio recombination lines are detected in both NGC 3576 (DV_{FWHM}>= 50 km/s) and NGC 3603 (DV_{FWHM}>=70 km/s). In NGC 3576 a prominent N-S velocity gradient (~30 km/s/pc) is observed, and a clear temperature gradient (6000 K to 8000 K) is found from east to west, consistent with a known IR color gradient in the source. In NGC 3603, the H90a, He90a and the H113b lines are detected from 13 individual sources. The Y^+ (He/H) ratios in the two sources range from 0.08+/-0.04 to 0.26+/-0.10. We compare the morphology and kinematics of the ionized gas at 3.4 cm with the distribution of stars, 10 micron emission and H_2O, OH, and CH_3OH maser emission. These comparisons suggest that both NGC 3576 and NGC 3603 have undergone sequential star formation.Comment: 24 pages, 12 Postscript figure

Effect of exenatide on splanchnic and peripheral glucose metabolism in type 2 diabetic subjects

OBJECTIVE: Our objective was to examine the mechanisms via which exenatide attenuates postprandial hyperglycemia in type 2 diabetes mellitus (T2DM). STUDY DESIGN: Seventeen T2DM patients (44 yr; seven females, 10 males; body mass index = 33.6 kg/m(2); glycosylated hemoglobin = 7.9%) received a mixed meal followed for 6 h with double-tracer technique ([1-(14)C]glucose orally; [3-(3)H]glucose i.v.) before and after 2 wk of exenatide. In protocol II (n = 5), but not in protocol I (n = 12), exenatide was given in the morning of the repeat meal. Total and oral glucose appearance rates (RaT and RaO, respectively), endogenous glucose production (EGP), splanchnic glucose uptake (75 g - RaO), and hepatic insulin resistance (basal EGP x fasting plasma insulin) were determined. RESULTS: After 2 wk of exenatide (protocol I), fasting plasma glucose decreased (from 10.2 to 7.6 mm) and mean postmeal plasma glucose decreased (from 13.2 to 11.3 mm) (P < 0.05); fasting and meal-stimulated plasma insulin and glucagon did not change significantly. After exenatide, basal EGP decreased (from 13.9 to 10.8 mumol/kg . min, P < 0.05), and hepatic insulin resistance declined (both P < 0.05). RaO, gastric emptying (acetaminophen area under the curve), and splanchnic glucose uptake did not change. In protocol II (exenatide given before repeat meal), fasting plasma glucose decreased (from 11.1 to 8.9 mm) and mean postmeal plasma glucose decreased (from 14.2 to 10.1 mm) (P < 0.05); fasting and meal-stimulated plasma insulin and glucagon did not change significantly. After exenatide, basal EGP decreased (from 13.4 to 10.7 mumol/kg . min, P = 0.05). RaT and RaO decreased markedly from 0-180 min after meal ingestion, consistent with exenatide\u27s action to delay gastric emptying. CONCLUSIONS: Exenatide improves 1) fasting hyperglycemia by reducing basal EGP and 2) postmeal hyperglycemia by reducing the appearance of oral glucose in the systemic circulation

An overview of clinical activities in Endo-ERN: the need for alignment of future network criteria

Objective Given that volumes of patients and interventions are important criteria to qualify as a reference centre (RC) for the European Reference Network on Rare Endocrine Conditions (Endo-ERN), the present study aimed to evaluate the data that were reported in the original application against subsequent assessments of activity and review the criteria that may define RCs using two main thematic groups (MTGs): Pituitary and Thyroid, as examples. Methods Review of content in application forms and continuous monitoring data and of a survey distributed to RCs. A list of ‘key procedures’ for the assessment of performance of RCs was composed with the help of the Pituitary and Thyroid MTG chairs. Results In the original application, the number of undefined procedures ranged from 20 to 5500/year (Pituitary) and from 10 to 2700/year (phyroid) between applicants. In the survey, the number of key procedures per centre ranged from 18 to 150/year (Pituitary) and from 20 to 1376/year (Thyroid). The median numbers of new patients reported in the continuous monitoring program were comparable with the application and survey; however, some centres reported large variations. Conclusions Monitoring of clinical activity in an ERN requires clear definitions that are optimally aligned with clinical practice, diagnosis registration, and hospital IT systems. This is a particular challenge in the rare disease field where the centre may also provide expert input in collaboration with local hospitals. Application of uniform definitions, in addition to condition-specific clinical benchmarks, which can include patient-reported- as well as clinician-reported outcome measures, is urgently needed to allow benchmarking of care across Endo-ERN

Metabolic effects of muraglitazar in type 2 diabetic subjects

AIM: To assess the effect of muraglitazar, a dual peroxisome proliferator-activated receptor (PPAR)gamma-alpha agonist, versus placebo on metabolic parameters and body composition in subjects with type 2 diabetes mellitus (T2DM). METHODS: Twenty-seven T2DM subjects received oral glucose tolerance test (OGTT), euglycaemic insulin clamp with deuterated glucose, measurement of total body fat (DEXA), quantitation of muscle/liver (MRS) and abdominal subcutaneous and visceral (MRI) fat, and then were randomized to receive, in addition to diet, muraglitazar (MURA), 5 mg/day, or placebo (PLAC) for 4 months. RESULTS: HbA1c(c) decreased similarly (2.1%) during both MURA and PLAC treatments despite significant weight gain with MURA (+2.5 kg) and weight loss with PLAC (-0.7 kg). Plasma triglyceride, LDL cholesterol, free fatty acid (FFA), hsCRP levels all decreased with MURA while plasma adiponectin and HDL cholesterol increased (p < 0.05-0.001). Total body (muscle), hepatic and adipose tissue sensitivity to insulin and beta cell function all improved with MURA (p < 0.05-0.01). Intramyocellular, hepatic and abdominal visceral fat content decreased, while total body and subcutaneous abdominal fat increased with MURA (p < 0.05-0.01). CONCLUSIONS: Muraglitazar (i) improves glycaemic control by enhancing insulin sensitivity and beta cell function in T2DM subjects, (ii) improves multiple cardiovascular risk factors, (iii) reduces muscle, visceral and hepatic fat content in T2DM subjects. Despite similar reduction in A1c with PLAC/diet, insulin sensitivity and beta cell function did not improve significantly

Elevated Toll-Like Receptor 4 Expression and Signaling in Muscle From Insulin-Resistant Subjects

OBJECTIVE— Tall-like receptor (TLR)4 has been implicated in the pathogenesis of free fatty acid (FFA)-induced insulin resistance by activating inflammatory pathways, including inhibitor of κB (IκB)/nuclear factor κB (NFκB). However, it is not known whether insulin-resistant subjects have abnormal TLR4 signaling. We examined whether insulin-resistant subjects have abnormal TLR4 expression and TLR4-driven (IκB/NFκB) signaling in skeletal muscle

Effect of Acute Exercise on AMPK Signaling in Skeletal Muscle of Subjects With Type 2 Diabetes

Activation of AMP-activated protein kinase (AMPK) by exercise induces several cellular processes in muscle. Exercise activation of AMPK is unaffected in lean (BMI ~25 kg/m2) subjects with type 2 diabetes. However, most type 2 diabetic subjects are obese (BMI \u3e30 kg/m2), and exercise stimulation of AMPK is blunted in obese rodents. We examined whether obese type 2 diabetic subjects have impaired exercise stimulation of AMPK, at different signaling levels, spanning from the upstream kinase, LKB1, to the putative AMPK targets, AS160 and peroxisome proliferator–activated receptor coactivator (PGC)-1α, involved in glucose transport regulation and mitochondrial biogenesis, respectively. Twelve type 2 diabetic, eight obese, and eight lean subjects exercised on a cycle ergometer for 40 min. Muscle biopsies were done before, during, and after exercise. Subjects underwent this protocol on two occasions, at low (50% VO2max) and moderate (70% VO2max) intensities, with a 4–6 week interval. Exercise had no effect on LKB1 activity. Exercise had a time- and intensity-dependent effect to increase AMPK activity and AS160 phosphorylation. Obese and type 2 diabetic subjects had attenuated exercise-stimulated AMPK activity and AS160 phosphorylation. Type 2 diabetic subjects had reduced basal PGC-1 gene expression but normal exercise-induced increases in PGC-1 expression. Our findings suggest that obese type 2 diabetic subjects may need to exercise at higher intensity to stimulate the AMPK-AS160 axis to the same level as lean subjects

Red wine polyphenols prevent metabolic and cardiovascular alterations associated with obesity in Zucker fatty rats (Fa/Fa)

Peer reviewedPublisher PD