Gestational diabetes: An overview with attention for developing countries

AbstractGestational diabetes mellitus (GDM) is defined as a glucose intolerance that occurs for the first time or it is first identified during pregnancy. The GDM etiology is multifactorial. It has not completely been established yet and several known risk factors may contribute to its onset. To date, there are no shared guidelines on the management and follow-up, especially regarding the low-income countries. In this paper, we describe the state of art about epidemiology, physiopathology, diagnosis, and management of GDM. Moreover, we focus on the current state in low income countries trying to outline basis for further research

Schistosomal appendicitis: Case series and systematic literature review

Background Globally, schistosomiasis affects at least 240 million people each year with a high proportion of cases in sub-Saharan Africa. The infection presents a wide range of symptoms mainly at the gastrointestinal and urogenital level. Cases of schistosomiasis-related appendicitis are seldom reported. The aim of the present study is to identify the prevalence of schistosomiasis-related appendicitis in Beira, Mozambique and compare to global prevalence. Methods We retrospectively reviewed all cases of appendicitis recorded from January 2017 to March 2020 at a single pathology department located in Beira in order to assess the prevalence of schistosomiasis. Moreover, we performed a systematic review on the prevalence of schistosomiasis-related appendicitis in all countries. Findings A total of 145 appendicitis cases in Beira showed a 13.1% prevalence of schistosomal-related appendicitis. The mean age of patients was 29.1 years, and 14 (73.7%) were male. The systematic review identified 20 studies with 34,790 inpatientsAUwith: schistosomiasis-related appendicitis with a global prevalence of 1.31% (95% confidence interval (CI): 0.72 to PerPLOSstyle; sufferingfrom2.06); a high heterogeneity (I2 = 96.0%) was observed. Studies carried out in Africa reported a significantly higher prevalence of schistosomiasis-related appendicitis (2.75%; 95% CI: 1.28 to 4.68) than those in Middle East (0.49%; 95% CI: 0.18 to 0.95) (p for interaction < 0.0001). Conclusions Schistosomiasis infection should be considered as possible cause of appendicitis not only in endemic areas but also in developed countries. Considering that prevention is the best way to control the infection, more efforts should be put in place in order to increase the prevention coverage and avoid the cascading implications for health. This is even more so important in this Coronavirus Disease 2019AU(COVID-19): PleasenotethatCOVIDera where the majority19hasbeendefinedasCoof attention and funds are used to fight the pandemic

Neuroprotective effects of ammonium tetrathiomolybdate, a slow-release sulfide donor, in a rodent model of regional stroke

BACKGROUND: Several therapeutic strategies to rescue the brain from ischemic injury have improved outcomes after stroke; however, there is no treatment as yet for reperfusion injury, the secondary damage caused by necessary revascularization. Recently we characterized ammonium tetrathiomolybdate (ATTM), a drug used as a copper chelator over many decades in humans, as a new class of sulfide donor that shows efficacy in preclinical injury models. We hypothesized that ATTM could confer neuroprotection in a relevant rodent model of regional stroke. METHODS AND RESULTS: Brain ischemia was induced by transient (90-min) middle cerebral artery occlusion (tMCAO) in anesthetized Wistar rats. To mimic a clinical scenario, ATTM (or saline) was administered intravenously just prior to reperfusion. At 24 h or 7 days post-reperfusion, rats were assessed using functional (rotarod test, spontaneous locomotor activity), histological (infarct size), and molecular (anti-oxidant enzyme capacity, oxidative damage, and inflammation) outcome measurements. ATTM-treated animals showed improved functional activity at both 24 h and 7-days post-reperfusion, in parallel with a significant reduction in infarct size. These effects were additionally associated with increased brain antioxidant enzyme capacity, decreased oxidative damage, and a late (7-day) effect on pro-inflammatory cytokine levels and nitric oxide products. CONCLUSION: ATTM confers significant neuroprotection that, along with its known safety profile in humans, provides encouragement for its development as a novel adjunct therapy for revascularization following stroke

Dexamethasone Treatment Reverses Cognitive Impairment but Increases Brain Oxidative Stress in Rats Submitted to Pneumococcal Meningitis

Pneumococcal meningitis is associated with a significant mortality rate and neurologic sequelae. The animals received either 10 μL of saline or a S. pneumoniae suspension and were randomized into different groups: sham: placebo with dexamethasone 0.7 mg/kg/1 day; placebo with dexamethasone 0.2 mg/kg/7 days; meningitis groups: dexamethasone 0.7 mg/kg/1 day and dexamethasone 0.2 mg/kg/7 days. Ten days after induction we evaluated memory and oxidative stress parameters in hippocampus and cortex. In the step-down inhibitory avoidance task, we observed memory impairment in the meningitis group with dexamethasone 0.2 mg/kg/7 days. The lipid peroxidation was increased in hippocampus in the meningitis groups with dexamethasone and in cortex only in the meningitis group with dexamethasone 0.2 mg/kg/7 days. The protein carbonyl was increased in hippocampus in the meningitis groups with dexamethasone and in cortex in the meningitis groups with and without dexamethasone. There was a decrease in the proteins integrity in hippocampus in all groups receiving treatment with dexamethasone and in cortex in all groups with dexamethasone (0.7 mg/kg/1 day). The mitochondrial superoxide was increased in the hippocampus and cortex in the meningitis group with dexamethasone 0.2 mg/kg/7 days. Our findings demonstrate that dexamethasone reverted cognitive impairment but increased brain oxidative stress in hippocampus and cortex in Wistar rats ten days after pneumococcal meningitis induction

Identification of most relevant variables and processes to assess the environmental impacts of remediation technologies along their life cycles: Focus on the waste management scenarios

The application of Life Cycle Assessment (LCA) to remediation technologies is still not a consolidated practice and it is especially lacking in the assessment of the environmental impacts associated to the management of the waste produced during remediation. This study aims at addressing these methodological gaps by identifying the typologies of waste typically generated during the remediation of a contaminated site and classifying them according to the European Waste Catalogue (EWC) codes. Thereafter, the following steps are: (i) the identification of the waste management scenarios (WMSs) applicable to the identified waste typologies, (ii) the selection of Life Cycle Assessment processes that can be used to assess the impacts of the different WMSs and (iii) the quantification and comparison of the environmental impacts caused by the different WMSs applied considering hazardousness levels to which the same waste may belong in relation to its contamination levels and characteristics: inert, non-hazardous and hazardous waste (Waste Framework Directive 2008/98/EC). As results, a matrix reporting the classes and typologies of waste, their EWC codes, their different WMSs and the suitable LCA processes from the Ecoinvent database that can be applied to each EWC within a specific WMS, has been developed. Additionally, the comparative assessment of the impacts caused by the Ecoinvent processes applicable to the same waste typology within the same WMS has been performed to support the selection of the most appropriate WMS case by case

Assessing uncertainty of hydrological and ecological parameters originating from the application of an ensemble of ten global-regional climate model projections in a coastal ecosystem of the lagoon of Venice, Italy

With increasing evidences of climate change affecting coastal waters, there is a strong need to understand future climate conditions and assess the potential responses of delicate coastal ecosystems. Results of climate change studies based on only one GCM-RCM combination should be interpreted with caution as results are highly dependent on the assumptions of the selected combination. In this study we examined the uncertainty in the hydrological and ecological parameters of the Zero river basin (ZRB) – Palude di Cona (PDC) coastal aquatic ecosystem generated by the adoption of an ensemble of climate projections from ten different combinations of General Circulation Model (GCM) – Regional Climate Model (RCM) under two emission scenarios (RCP4.5 and RCP8.5) implemented in the hydrological model (SWAT) and the ecological model (AQUATOX). The baseline period of 1983–2012 was used to identify climate change variations in two future periods: mid-century (2041–2070) and late-century (2071–2100) periods. SWAT outputs from the ensemble indicate a summer reduction in inorganic nitrogen loadings of 1–22% and a winter increase of 1–19%. Inorganic phosphorus loadings indicate a yearly increase of 32–61%. AQUATOX outputs from the ensemble show major changes in the summer period, with an increase in Chl-a concentration of 9–56%, a decrease in diatoms of 74–98% and an increase in cyanobacteria of 421–3590%. Obtained results confirm that the use of multiple GCM-RCM projections can provide a more robust assessment of climate change impacts on the hydrology and ecology of coastal waters, but at the same time highlight the large uncertainty of climate change-related impact studies, which can affect the decision-making processes regarding the management and preservation of sensitive aquatic ecosystems such as those in coastal areas. © 2019 Elsevier B.V

Increased Oxidative Stress and Imbalance in Antioxidant Enzymes in the Brains of Alloxan-Induced Diabetic Rats

Diabetes Mellitus (DM) is associated with pathological changes in the central nervous system (SNC) as well as alterations in oxidative stress. Thus, the main objective of this study was to evaluate the effects of the animal model of diabetes induced by alloxan on memory and oxidative stress. Diabetes was induced in Wistar rats by using a single injection of alloxan (150 mg/kg), and fifteen days after induction, the rats memory was evaluated through the use of the object recognition task. The oxidative stress parameters and the activity of antioxidant enzymes, superoxide dismutase (SOD), and catalase (CAT) were measured in the rat brain. The results showed that diabetic rats did not have alterations in their recognition memory. However, the results did show that diabetic rats had increases in the levels of superoxide in the prefrontal cortex, and in thiobarbituric acid reactive species (TBARS) production in the prefrontal cortex and in the amygdala in submitochondrial particles. Also, there was an increase in protein oxidation in the hippocampus and striatum, and in TBARS oxidation in the striatum and amygdala. The SOD activity was decreased in diabetic rats in the striatum and amygdala. However, the CAT activity was increased in the hippocampus taken from diabetic rats. In conclusion, our findings illustrate that the animal model of diabetes induced by alloxan did not cause alterations in the animals' recognition memory, but it produced oxidants and an imbalance between SOD and CAT activities, which could contribute to the pathophysiology of diabetes

Ammonium tetrathiomolybdate following ischemia/reperfusion injury: Chemistry, pharmacology, and impact of a new class of sulfide donor in preclinical injury models

Background: Early revascularization of ischemic organs is key to improving outcomes, yet consequent reperfusion injury may be harmful. Reperfusion injury is largely attributed to excess mitochondrial production of reactive oxygen species (ROS). Sulfide inhibits mitochondria and reduces ROS production. Ammonium tetrathiomolybdate (ATTM), a copper chelator, releases sulfide in a controlled and novel manner, and may offer potential therapeutic utility. Methods and findings: In vitro, ATTM releases sulfide in a time-, pH-, temperature-, and thiol-dependent manner. Controlled sulfide release from ATTM reduces metabolism (measured as oxygen consumption) both in vivo in awake rats and ex vivo in skeletal muscle tissue, with a superior safety profile compared to standard sulfide generators. Given intravenously at reperfusion/resuscitation to rats, ATTM significantly reduced infarct size following either myocardial or cerebral ischemia, and conferred survival benefit following severe hemorrhage. Mechanistic studies (in vitro anoxia/reoxygenation) demonstrated a mitochondrial site of action (decreased MitoSOX fluorescence), where the majority of damaging ROS is produced. Conclusions: The inorganic thiometallate ATTM represents a new class of sulfide-releasing drugs. Our findings provide impetus for further investigation of this compound as a novel adjunct therapy for reperfusion injury

Physical Multimorbidity and Sarcopenia among Adults Aged ≥65 Years in Low- and Middle-Income Countries

Introduction: Physical multimorbidity is plausibly linked to sarcopenia. However, to date, only a few studies exist on this topic, and none have examined this association in low- and middle-income countries (LMICs). Thus, we aimed to investigate the association between multimorbidity and sarcopenia in a sample of older adults from six LMICs (China, Ghana, India, Mexico, Russia, South Africa). Methods: Cross-sectional, community-based data from the WHO Study on Global Ageing and Adult Health (SAGE) were analysed. Sarcopenia was defined as having low skeletal muscle mass (SMM) and weak handgrip strength, while severe sarcopenia was defined as having low SMM, weak handgrip strength, and slow gait speed. A total of 11 physical chronic conditions were assessed and multimorbidity referred to ≥2 chronic conditions. Multivariable logistic regression analysis was conducted. Results: Data on 14,585 adults aged ≥65 years were analysed (mean age 72.6 years, SD 11.5 years; 53.7% females). Adjusted estimates showed that compared to no chronic physical conditions, ≥2 conditions are significantly associated with 1.49 (95% CI = 1.02–2.19) and 2.52 (95% CI = 1.53–4.15) times higher odds for sarcopenia and severe sarcopenia, respectively. Conclusions: In this large sample of older adults from LMICs, physical multimorbidity was significantly associated with sarcopenia and severe sarcopenia. Our study results tentatively suggest that targeting those with multimorbidity may aid in the prevention of sarcopenia, pending future longitudinal research