Treatment-induced neuropathy of diabetes in an adolescent with rapid reduction in HbA1c and weight loss:Persistent neuropathic findings at follow-up after 1.5 years

Treatment‐induced neuropathy of diabetes (TIND) is a condition occurring within weeks after a rapid decline in blood glucose. This case report illustrates consequences in an adolescent with TIND. Gold standard methods diagnosing large fiber, small fiber, and autonomic neuropathy were abnormal at 1.5 years of follow‐up. Awareness of TIND is important

Lone wolfs: How ostracism and trust relate to conspiracy theories

Samsæriskenningar hafa á undanförnum árum komið fram af krafti í sviðsljósið, ekki síst vegna aukins upplýsingaflæðis, stórvægilegra atburða í heilbrigðismálum og pólitísks landslags hins vestræna heims. Í rannsókn þessari var trú fólks á samsæriskenningar skoðuð í ljósi þátta sem eiga rætur sínar að rekja til ýmist sálfræði eða félagsfræði. Þar var hugtakið um útskúfun (e. ostracism) í lykilhlutverki en einnig traust, bæði félagslegt og pólitískt. Rannsóknin byggðist á á hentugleikaúrtaki 944 þátttakenda sem svöruðu spurningalista á netinu í árslok 2022. Markmið rannsóknarinnar var að sýna fram á ýmist jákvæð eða neikvæð tengsl hugsmíðanna tveggja við trú fólks á samsæriskenningar, samspil milli trausts og útskúfunar til að skýra trú á samsæriskenningar auk þess hvort tímabundin ýfing á útskúfunartilfinningu tengdist aukinni trú á samsæriskenningar, samanborið við þá sem ekki fengu slíka ýfingu. Niðurstöður leiddu í ljós jákvæð tengsl milli upplifaðrar útskúfunar og trúar fólks á samsæriskenningar, þar sem sá hópur þátttakenda sem upplifði meiri útskúfun, mældist með hærra meðaltal á samsæriskenningakvarða en þeir sem upplifðu litla eða enga útskúfun. Niðurstöður leiddu jafnframt í ljós marktæk neikvæð tengsl trausts, félagslegs og pólitísks, við trú á samsæriskenningar og jákvæð tengsl vantrausts og tortryggni við trú á samsæriskenningar. Tilgáta rannsakenda sem laut að ýfingu útskúfunar stóðst ekki, þar sem tilraun sýndi fram á gagnstæð áhrif þess Aðeins mældist marktæk samvirkni milli tveggja traust-breyta af átta annars vegar og útskúfunar hins vegar. Ljóst er af niðurstöðum að útskúfun virðist tengjast aukinni trú á samsæriskenningar, sem er athyglisvert í ljósi þess hversu fáar rannsóknir hafa skoðað efnið með beinum hætti. Þá renna niðurstöður um traust stoðum undir fyrri rannsóknir. Gagnstæð áhrif tilraunainngrips þótti rannsakendum athyglisverð og verð til frekari athugunar í framtíðarrannsóknum

Study protocol: fish oil supplement in prevention of oxaliplatin-induced peripheral neuropathy in adjuvant colorectal cancer patients – a randomized controlled trial. (OxaNeuro)

Abstract Background Oxaliplatin-induced peripheral neuropathy (OIPN) in general and painful OIPN in particular is a debilitating late effect that severely affects cancer survivors’ quality of life and causes premature cessation of potentially lifesaving treatment. No preventive treatments and no effective treatment for chronic OIPN exist despite many attempts. One of several suggested mechanisms includes neuroinflammation as a contributing factor to OIPN. Fish oil containing long-chain n-3 polyunsaturated fatty acids (n-3 LCPUFAs) are precursors to specialized proresolving mediators that mediate the resolution of inflammation. Our primary hypothesis is that a high supplementation of n-3 LCPUFAs will lower the prevalence and severity of OIPN. Methods The OxaNeuro project is an investigator-initiated, multicenter, double-blinded, randomized, placebo-controlled clinical study. We will include 120 patients eligible to receive adjuvant oxaliplatin after colorectal cancer surgery. Patients will receive fish oil capsules containing n-3 LCPUFAs or corn oil daily for 8 months. The primary endpoint is the prevalence of OIPN at 8 months defined as relevant symptoms, including one of the following: abnormal nerve conduction screening, abnormal vibration threshold test, abnormal skin biopsy, or abnormal pinprick test. Additional endpoints include the intensity and severity of OIPN-related neuropathic pain, patient-reported OIPN symptoms, quality of life, mental health symptoms, body composition, and cognitive evaluation. Furthermore, we will evaluate inflammatory biomarkers in blood samples and skin biopsies, including the potential OIPN biomarker neurofilament light protein (NfL) which will be measured before each cycle of chemotherapy. Discussion If readily available fish oil supplementation alleviates OIPN prevalence and severity, it will significantly improve the lives of both cancer survivors and palliative cancer patients receiving oxaliplatin; it will improve their quality of life, optimize chemotherapeutic treatment plans by lowering the need for dose reduction or premature cessation, and potentially increase survival. Trial registration ClinicalTrial.gov identifier: NCT05404230 Protocol version: 1.2, April 25th. 202

Ageing promotes pathological alpha-synuclein propagation and autonomic dysfunction in wild-type rats

Neuronal aggregates of misfolded alpha-synuclein protein are found in the brain and periphery of patients with Parkinson’s disease. Braak and colleagues have hypothesized that the initial formation of misfolded alpha-synuclein may start in the gut, and then spread to the brain via peripheral autonomic nerves hereby affecting several organs, including the heart and intestine. Age is considered the greatest risk factor for Parkinson’s disease, but the effect of age on the formation of pathology and its propagation has not been studied in detail. We aimed to investigate whether propagation of alpha-synuclein pathology from the gut to the brain is more efficient in old versus young wild-type rats, upon gastrointestinal injection of aggregated alpha-synuclein. Our results demonstrate a robust age-dependent gut-to-brain and brain-to-gut spread of alpha-synuclein pathology along the sympathetic and parasympathetic nerves, resulting in age-dependent dysfunction of the heart and stomach, as observed in patients with Parkinson’s disease. Moreover, alpha-synuclein pathology is more densely packed and resistant to enzymatic digestion in old rats, indicating an age-dependent maturation of alpha-synuclein aggregates. Our study is the first to provide a detailed investigation of alpha-synuclein pathology in several organs within one animal model, including the brain, skin, heart, intestine, spinal cord and autonomic ganglia. Taken together, our findings suggest that age is a crucial factor for alpha-synuclein aggregation and complete propagation to heart, stomach and skin, similar to patients. Given that age is the greatest risk factor for human Parkinson’s disease, it seems likely that older experimental animals will yield the most relevant and reliable findings. These results have important implications for future research to optimize diagnostics and therapeutics in Parkinson’s disease and other age-associated synucleinopathies. Increased emphasis should be placed on using aged animals in preclinical studies and to elucidate the nature of age-dependent interactions