Cognitive impairment in patients with type 2 diabetes mellitus: prevalence, pathogenetic mechanisms, the effect of antidiabetic drugs

In recent years, a large amount of data has been accumulated on the relationship between cognitive impairment, dementia and diabetes mellitus. This article presents an overview of modern literature, including the definition of cognitive functions, the modern classification of cognitive impairment, pathogenetic mechanisms of diabetes mellitus influence on the development of cognitive impairment and dementia (neurogenesis, integrity of the blood-brain barrier, systemic inflammatory reactions, hyper- and hypoglycemia, insulin resistance, vascular dysfunction of the microvasculature and increase in glucocorticosteroids). The influence of anti-diabetic medications on cognitive functions has been examined in detail: insulin preparations, oral hypoglycemic agents of the biguanide group (metformin), thiazolidinediones (rosiglitazone and pioglitazone), sulfonylurea derivatives (glycazide, glipizide), a-glucosidase (acarbose) inhibitors, incretin-directed therapy (receptor agonists glucan-like peptide (exenatide and liraglutide) and inhibitors of dipeptidylpeptidase type 4 (sitagliptin, vildagliptin and alogliptin)), sodium glucose inhibitors cotransporter type 2. The data demonstrating a multidirectional effect on the cognitive functions of various antidiabetic drugs is presented, the possible influence on the rate of progression of cognitive impairment and the risk of dementia of intensive control of plasma glucose level in comparison with the standard decrease in patients with type 2 diabetes is analyzed

Developing a company-specific job exposure matrix for the Asbest Chrysotile Cohort Study

OBJECTIVES: Exposure assessment for retrospective industrial cohorts are often hampered by limited availability of historical measurements. This study describes the development of company-specific job-exposure matrices (JEMs) based on measurements collected over five decades for a cohort study of 35 837 workers (Asbest Chrysotile Cohort Study) in the Russian Federation to estimate their cumulative exposure to chrysotile containing dust and fibres. METHODS: Almost 100 000 recorded stationary dust measurements were available from 1951-2001 (factories) and 1964-2001 (mine). Linear mixed models were used to extrapolate for years where measurements were not available or missing. Fibre concentrations were estimated using conversion factors based on side-by-side comparisons. Dust and fibre JEMs were developed and exposures were allocated by linking them to individual workers' detailed occupational histories. RESULTS: The cohort covered a total of 515 355 employment-years from 1930 to 2010. Of these individuals, 15% worked in jobs not considered professionally exposed to chrysotile. The median cumulative dust exposure was 26 mg/m3 years for the entire cohort and 37.2 mg/m3 years for those professionally exposed. Median cumulative fibre exposure was 16.4 fibre/cm3 years for the entire cohort and 23.4 fibre/cm3 years for those professionally exposed. Cumulative exposure was highly dependent on birth cohort and gender. Of those professionally exposed, women had higher cumulative exposures than men as they were more often employed in factories with higher exposure concentrations rather than in the mine. CONCLUSIONS: Unique company-specific JEMs were derived using a rich measurement database that overlapped with most employment-years of cohort members and will enable estimation of quantitative exposure-response

Subclinical Hypothyroidism after Radioiodine Exposure: Ukrainian–American Cohort Study of Thyroid Cancer and Other Thyroid Diseases after the Chornobyl Accident (1998–2000)

BackgroundHypothyroidism is the most common thyroid abnormality in patients treated with high doses of iodine-131 (131I). Data on risk of hypothyroidism from low to moderate 131I thyroid doses are limited and inconsistent.ObjectiveThis study was conducted to quantify the risk of hypothyroidism prevalence in relation to 131I doses received because of the Chornobyl accident.MethodsThis is a cross-sectional (1998-2000) screening study of thyroid diseases in a cohort of 11,853 individuals < 18 years of age at the time of the accident, with individual thyroid radioactivity measurements taken within 2 months of the accident. We measured thyroid-stimulating hormone (TSH), free thyroxine, and antibodies to thyroid peroxidase (ATPO) in serum.ResultsMean age at examination of the analysis cohort was 21.6 years (range, 12.2-32.5 years), with 49% females. Mean 131I thyroid dose was 0.79 Gy (range, 0-40.7 Gy). There were 719 cases with hypothyroidism (TSH > 4 mIU/L), including 14 with overt hypothyroidism. We found a significant, small association between (131)I thyroid doses and prevalent hypothyroidism, with the excess odds ratio (EOR) per gray of 0.10 (95% confidence interval, 0.03-0.21). EOR per gray was higher in individuals with ATPO < or = 60 U/mL compared with individuals with ATPO > 60 U/mL (p < 0.001).ConclusionsThis is the first study to find a significant relationship between prevalence of hypothyroidism and individual (131)I thyroid doses due to environmental exposure. The radiation increase in hypothyroidism was small (10% per Gy) and limited largely to subclinical hypothyroidism. Prospective data are needed to evaluate the dynamics of radiation-related hypothyroidism and clarify the role of antithyroid antibodies

Long-term strategies for thyroid health monitoring after nuclear accidents : recommendations from an Expert Group convened by IARC

International audience[No abstract available

Soluble Cyanobacterial Carotenoprotein as a Robust Antioxidant Nanocarrier and Delivery Module

To counteract oxidative stress, antioxidants including carotenoids are highly promising, yet their exploitation is drastically limited by the poor bioavailability and fast photodestruction, whereas current delivery systems are far from being efficient. Here we demonstrate that the recently discovered nanometer-sized water-soluble carotenoprotein from Anabaena sp. PCC 7120 (termed AnaCTDH) transiently interacts with liposomes to efficiently extract carotenoids via carotenoid-mediated homodimerization, yielding violet–purple protein samples. We characterize the spectroscopic properties of the obtained pigment–protein complexes and the thermodynamics of liposome–protein carotenoid transfer and demonstrate the delivery of carotenoid echinenone from AnaCTDH into liposomes with an efficiency of up to 70 ± 3%. Most importantly, we show efficient carotenoid delivery to membranes of mammalian cells, which provides protection from reactive oxygen species (ROS). Incubation of neuroblastoma cell line Tet21N in the presence of 1 μM AnaCTDH binding echinenone decreased antimycin A ROS production by 25% (p < 0.05). The described carotenoprotein may be considered as part of modular systems for the targeted antioxidant delivery.BMBF, 01DJ15007, Carotenoidbindende photoschaltbare Proteine: Lichtinduzierte Dynamik und Anwendungen in modernen mikroskopischen Verfahre

Thyroid Health Monitoring After Nuclear Accidents : IARC Expert Group on Thyroid Health Monitoring After Nuclear Accidents

This Technical Publication contains the forward-looking recommendations of a multidisciplinary, international Expert Group on long-term strategies for thyroid health monitoring after a nuclear power plant accident. As a basis for the recommendations, this publication also summarizes the available scientific evidence on thyroid cancer and experiences from past nuclear accidents. The recommendations are intended to specifically address whether thyroid health monitoring should be implemented in a resident population in the vicinity of a nuclear accident and, if so, how such thyroid health monitoring should be prepared for and implemented in the context of general emergency preparedness for and response to nuclear accidents. This publication was developed with the intention to serve as a reference primarily for the government officials, policy-makers, and health professionals who would be involved in the decision-making, planning, or implementation of thyroid health monitoring in case of a nuclear accident. Because such decision-making may also involve considerations other than the scientific evidence, these recommendations should be used as a reference; the final decision should be made by the government, the relevant authorities, and the society affected by the nuclear accident. This Technical Publication consists of five chapters: the executive summary (Chapter 1), the introduction (Chapter 2), the Expert Group’s recommendations and considerations related to thyroid health monitoring in the context of preparedness for and response to nuclear accidents (Chapter 3), summaries and syntheses of the scientific evidence base used by the Expert Group when developing the recommendations (Chapter 4), and the identified gaps in scientific knowledge (Chapter 5).4

Induction of Late-onset Spontaneous Autoimmune Thyroiditis by a Single Low-dose Irradiation in Thyroiditis-prone Non-obese Diabetic-H2h4 Mice

The previous data regarding the effect of irradiation on thyroid autoimmunity are controversial. We have recently reported the exacerbation of autoimmune thyroiditis by a single low dose (0.5 Gy) of whole body irradiation in thyroiditis-prone non-obese diabetic (NOD)-H2h4 mice treated with iodine for 8 weeks. However, it is uncertain in that report whether the results obtained by the provision of iodine in a relatively short period of time (8 weeks) accurately reflects the long-term consequences of low-dose irradiation on thyroid autoimmunity. Therefore, we repeated these experiments with mice that were monitored after irradiation without iodine treatment for up to 15 months. We found that a single low-dose (0.5 Gy) irradiation increased the incidence and severity of thyroiditis and the incidence and titers of anti-thyroglobulin autoantibodies at 15 months of age. The numbers of splenocytes and percentages of various lymphocyte subsets were not affected by irradiation. Thus, we conclude that low-dose irradiation also exacerbates late-onset spontaneous thyroiditis in NOD-H2h4 mice; one plausible explanation for this may be the acceleration of immunological aging by irradiation

Aspects of economic costs and evaluation of health surveillance systems after a radiation accident with a focus on an ultrasound thyroid screening programme for children

Health surveillance initiatives targeted at populations evacuated from, and residing in, areas affected by radiation contamination were implemented by international institutions as well as national and local governments after the nuclear accidents of Chernobyl and Fukushima Dai-ichi nuclear power plants. Most of these initiatives included a component of childhood thyroid cancer monitoring, with the more comprehensive schemes corresponding to national programmes of health monitoring for adults and children around general health and wellbeing. This article provides a short overview of available data on the costs and resources associated with surveillance responses to two recent nuclear accidents: Chernobyl and the Fukushima Dai-Ichi nuclear plant accidents. Moreover, because the balance of costs and benefits of health surveillance after a nuclear accident can influence decisions on implementation, we also present a brief overview of the principles of economic evaluation for collecting and presenting data on costs and outcomes of a surveillance programme after a nuclear accident. We apply these principles in a balance sheet analysis of a post-accident ultrasound thyroid screening programme for children