A Central Pathological Mechanism Explaining Diabetic Complications?

peer reviewedDiabetes mellitus is associated to micro- and macro-vascular lesions responsible for myocardial infarction, nephropathy, retinopathy and polyneuropathy. Four main pathogenic mechanisms have been proposed, all associated with hyperglycaemia: 1) increased flux in the polyol pathway; 2) increased flux in the hexosamine pathway; 3) protein kinase C activation; and 4) increased formation of advanced glycation endproducts. A common mechanism seems to play a central role in the activation of these various pathways. Indeed, an increased production of free radicals by mitochondria induced by hyperglycaemia may be responsible for the observed metabolic disturbances. The present article describes that theory and presents its possible therapeutic implications

What is the digital internal market and where the European Union should intervene?

This paper analyses the digital internal market and when EU intervention is needed to achieve this internal market. It sets legal and economic criteria to determine the appropriate scope of the EU intervention. It applies these criteria to several case studies and concludes that sometimes the EU intervention is not justified (choice of regulatory remedies in many national markets, regulation of mobile termination rate, price control of Next Generation Access networks), whereas in other cases EU intervention is justified (entry regulation, international roaming, spectrum). The paper calls for a more open debate of the concept and the means to achieve the digital internal market. It also submits that EU intervention should focus on the areas where its benefits are the highest (in particular given the possibilities of economies of scale provided by the technology or the cross-country externalities), and where its costs are the lowest (in particular given the heterogeneity of national preferences or the need for regulatory experimentation and competition). Therefore, EU intervention is more relevant for the content part of digital regulation (such as copyright, privacy, electronic commerce, dispute resolution) than for the infrastructure part (i.e. the electronic communications networks and services). In particular, this paper calls the Commission to use with extreme caution its new power on regulatory remedies, especially in the context of the deployment of NGA, given the uncertainty on the best form of regulation.digital internal market; level of intervention; regulatory remedies

CPB AND AORTIC SURGERY The state of the Art (From a Theoritical to a Practical Approach)

Background Despite recent improvements in prevention, medical treatment [1]and endovascular aortic repair , invasive surgery associated with cardiopulmonary bypass (CPB) remains the best option of treatment for some patients. The aim of this study is to make a review of the specific CPB protocols associated with these invasive surgical approaches, based on our clinical experience and according to the recent literature. Up to now, these protocols are not supported by evidence based in medicine (EBM) [2] or in perfusion (EBP). Discrepancies can be observed regarding target temperature , selective cerebral protection , CPB circuit concept and arterial cannulation sites . Variables guidelines are suggested concerning regional flow , transfusion requirements [3], coagulation monitoring blood gas management[4] as for cerebral and CPB monitoring tools. Conclusions In the absence of EBM and EBP in the aortic surgery field, the short and long terms clinical outcomes of the patients elected to invasive surgery for aortic diseases must guide and substantiate our choices of techniques and of CPB protocols