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Diabetes type 1: Can it be treated as an autoimmune disorder?

Type 1 Diabetes Mellitus (T1DM) is characterized by progressive autoimmune-mediated destruction of the pancreatic beta-cells leading to insulin deficiency and hyperglycemia. It is associated with significant treatment burden and necessitates life-long insulin therapy. The role of immunotherapy in the prevention and management of T1DM is an evolving area of interest which has the potential to alter the natural history of this disease. In this review, we give insight into recent clinical trials related to the use of immunotherapeutic approaches for T1DM, such as proinflammatory cytokine inhibition, cell-depletion and cell-therapy approaches, autoantigen-specific treatments and stem cell therapies. We highlight the timing of intervention, aspects of therapy including adverse effects and the emergence of a novel lymphocyte crucial in T1DM autoimmunity. We also discuss the role of cardiac autoimmunity and its link to excess CVD risk in T1DM. We conclude that significant advances have been made in development of immunotherapeutic targets and agents for the treatment and prevention of T1DM. These immune-based therapies promise preservation of beta-cells and decreasing insulin dependency. In their current state, immunotherapeutic approaches cannot yet halt the progression from a preclinical state to overt T1DM nor can they replace standard insulin therapy in existing T1DM. It remains to be seen whether immunotherapy will ultimately play a key role in the prevention of progression to overt T1DM and whether it may find a place in our therapeutic armamentarium to improve clinical outcomes and quality of life in established T1DM. © 2021, This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply

Measurements of atmospheric C₁₀–C₁₅ biogenic volatile organic compounds (BVOCs) with sorbent tubes

Biogenic volatile organic compounds (BVOCs; e.g. terpenes) are highly reactive compounds typically present at sub-parts-per-billion mole fractions in the air. Due to this, their measurements are challenging and they may suffer losses during sampling, storage and analyses. Even though online measurements of BVOCs are becoming more common, the use of sorbent tubes is expected to continue because they offer greater spatial coverage compared to online measurements, and no infrastructure (e.g. electricity, housing/shelter with stable temperature and humidity, sampling lines) is required for sampling. In this study, the performance of an offline technique for the measurement of BVOCs based on sorbent tube sampling was evaluated. Tested compounds included eight monoterpenes, five sesquiterpenes and five oxygenated BVOCs, which are generally either directly emitted (1,8-cineol, linalool, bornyl acetate) or oxidation products (nopinone and 4-acetyl-1-methylcyclohexene). Two sorbent materials (Tenax TA and Carbopack B) and four tube materials (stainless steel (SS), SilcoNert 1000, glass and glass-coated SS) were used. The laboratory evaluations determined the storage stability, breakthrough volumes, suitable tube materials, recovery from ozone scrubbers and particulate filters, and sampling efficiency. In addition, an intercomparison between two laboratories was conducted. No multibed configurations were tested. Of the sorbent materials Tenax TA showed acceptable results for these BVOCs, while with Carbopack B losses and increases in some compounds were detected. Studied compounds were found to be stable in Tenax TA tubes for at least 1 month at −20 and at +20 ∘C. Breakthrough tests indicated that α- and β-pinene have clearly lower breakthrough volumes in the Tenax TA tubes used (4–7 and 8–26 L, respectively) than other terpenes (&gt; 160 L). SS, SilcoNert 1000 and glass were all shown to be suitable tube materials. Results from Tenax TA sorbent tube sampling agreed with online sampling for most compounds. Heated SS tubes, sodium thiosulfate filters and KI/Cu traps were found to be suitable ozone scrubbers for the studied BVOCs. Tested particle filters had a greater impact on limonene (relative difference &lt; +7 %) than on α- and β-pinene (relative difference ±2 %). The laboratory intercomparison of α- and β-pinene measurements showed that in general, measured values by the two laboratories were in good agreement with Tenax TA.</p

Integrating GDPR in ISO 15189 for Medical Laboratories: Major Aspects and Perspectives

Medical laboratories process and store sensitive data during four major phases: arrival of patients in the laboratory premises and registration of their data, pre-analytical, analytical and post-analytical phases. ISO 15189 has specific requirements concerning the management of the laboratory data in terms of security, availability and protection. The aim of the present study was to examine major aspects of the General Data Protection Regulation (GDPR) integration in medical laboratories that comply with the ISO 15189 standard, including data breach and informed consent. To the best of our knowledge, this is the first study dealing with this subject in the healthcare sector. Accredited medical laboratories need to modify their ISO 15189 Quality System documentation and processes applying appropriate additions and adjustments in order to incorporate GDPR requirements in a clear manner. © 2019 The authors and IOS Press. All rights reserved

Remote monitoring of patients in quarantine in the era of SARS-CoV-2 pandemic

The aim of our study is to propose a remote patient monitoring solution through a smart phone application (Smart Patient) collecting health data to support diagnosis, monitoring and predicting poor outcome in asymptomatic/mild cases of COVID-19, including signs and symptoms, risk factors, comorbidities, medications and vital signs such as body temperature, respiratory rate, heart rate and oxygen saturation. By continuous daily recording of suspected cases and patients, family doctors in the community will be able to follow up cases and intervene promptly when deterioration in vital signs and symptoms takes place referring the patient to the hospital. © 2020 The authors and IOS Press

Hyperirisinemia is independently associated with subclinical hypothyroidism: correlations with cardiometabolic biomarkers and risk factors

Purpose: Irisin, a newly discovered adipo-myokine, is implicated in the modulation of the adipose phenotype, increasing energy expenditure and ameliorating systemic metabolism. Our aim was to investigate circulating irisin in subclinical hypothyroidism (SH) and study its associations with cardiometabolic risk factors. Methods: In a large case–control study, serum irisin, insulin resistance and lipid parameters, classic adipokines, inflammatory and hepatic biomarkers, and cardiovascular risk factors were determined in 120 consecutive patients with SH and 120 healthy controls matched on age, gender, and date of blood draw. Sixteen patients with SH received L-T4 treatment and, after 6 months, serum irisin and other biomarkers were assessed. Results: SH cases exhibited significantly higher circulating irisin than controls (p &lt; 0.001). In all participants, irisin was positively associated with TSH, anti-TG, HOMA-IR, C-peptide, lipid and inflammatory biomarkers, leptin, and cardiovascular risk factors, including Framigham score and apolipoprotein B/apolipoprotein A-I. Irisin was negatively correlated with adiponectin, HDL-C, and thyroid hormones. Serum irisin was independently associated with SH, above and beyond body mass index and cardiometabolic factors (p = 0.02). TSH was an independent predictor of circulating irisin (p = 0.003). L-T4 therapy did not reverse considerably the hyperirisinemic status in treated SH patients (p = 0.09). Conclusions: Irisin may represent an adipo-myokine counterbalancing a potential, gradual deterioration of lipid metabolism and insulin sensitivity in SH as well as reflecting a protective compensatory mechanism against oxidative muscle and thyroid cell stress. More mechanistic and prospective studies shedding light on the pathogenetic role of irisin in SH are needed to confirm and extend these data. © 2018, Springer Science+Business Media, LLC, part of Springer Nature