Mangosteen Extract Shows a Potent Insulin Sensitizing Effect in Obese Female Patients: A Prospective Randomized Controlled Pilot Study.

There is a widely acknowledged association between insulin resistance and obesity/type 2 diabetes (T2DM), and insulin sensitizing treatments have proved effective in preventing diabetes and inducing weight loss. Obesity and T2DM are also associated with increased inflammation. Mangosteen is a tropical tree, whose fruits—known for their antioxidant properties—have been recently suggested having a possible further role in the treatment of obesity and T2DM. The objective of this pilot study has been to evaluate safety and efficacy of treatment with mangosteen extract on insulin resistance, weight management, and inflammatory status in obese female patients with insulin resistance. Twenty-two patients were randomized 1:1 to behavioral therapy alone or behavioral therapy and mangosteen and 20 completed the 26-week study. The mangosteen group reported a significant improvement in insulin sensitivity (homeostatic model assessment-insulin resistance, HOMA-IR −53.22% vs. −15.23%, p = 0.004), and no side effect attributable to treatment was reported. Given the positive preliminary results we report and the excellent safety profile, we suggest a possible supplementary role of mangosteen extracts in the treatment of obesity, insulin resistance, and inflammation

Grammatical Distinctions in the Left Frontal Cortex

Selective deficits in producing verbs relative to nouns in speech are well documented in neuropsychology and have been associated with left hemisphere frontal cortical lesions resulting from stroke and other neurological disorders. The basis for these impairments is unresolved: Do they arise because of differences in the way grammatical categories of words are organized in the brain, or because of differences in the neural representation of actions and objects? We used repetitive transcranial magnetic stimulation (rTMS) to suppress the excitability of a portion of left prefrontal cortex and to assess its role in producing nouns and verbs. In one experiment subjects generated real words; in a second, they produced pseudowords as nouns or verbs. In both experiments, response latencies increased for verbs but were unaffected for nouns following rTMS. These results demonstrate that grammatical categories have a neuroanatomical basis and that the left prefrontal cortex is selectively engaged in processing verbs as grammatical objects.Psycholog

Movements execution in amnestic mild cognitive impairment and Alzheimer's disease.

We evaluated the relationship between motor and neuropsychological deficits in subjects affected by amnestic Mild Cognitive Impairment (aMCI) and {early} Alzheimer's Disease (AD). Kinematics of goal-directed movement of aMCI and AD subjects were compared to those of age-matched control subjects. AD showed a slowing down of motor performance compared to aMCI and controls. No relationships were found between motor and cognitive performances in both AD and aMCI. Our results suggest that the different motor behaviour between AD and aMCI cannot be related to memory deficits, probably reflecting the initial degeneration of parietal-frontal circuits for movement planning. The onset of motor dysfunction in early AD could represent the transition from aMCI to AD

Ketogenic diet as a preventive and supportive care for covid-19 patients

Severe obesity is associated with an increased risk of admission to intensive care units and need for invasive mechanical ventilation in patients with COVID-19. The association of obesity and COVID-19 prognosis may be related to many different factors, such as chronic systemic inflammation, the predisposition to severe respiratory conditions and viral infections. The ketogenic diet is an approach that can be extremely effective in reducing body weight and visceral fat in the short term, preserving the lean mass and reducing systemic inflammation. Therefore, it is a precious preventive measure for severely obese people and may be considered as an adjuvant therapy for patients with respiratory compromise

Intracranial measurement of current densities induced by transcranial magnetic stimulation in the human brain

Transcranial magnetic stimulation (TMS) is a non-invasive technique that uses the principle of electromagnetic induction to generate currents in the brain via pulsed magnetic fields. The magnitude of such induced currents is unknown. In this study we measured the TMS induced current densities in a patient with implanted depth electrodes for epilepsy monitoring. A maximum current density of 12 microA/cm2 was recorded at a depth of 1 cm from scalp surface with the optimum stimulation orientation used in the experiment and an intensity of 7% of the maximal stimulator output. During TMS we recorded relative current variations under different stimulating coil orientations and at different points in the subject's brain. The results were in accordance with current theoretical models. The induced currents decayed with distance form the coil and varied with alterations in coil orientations. These results provide novel insight into the physical and neurophysiological processes of TMS

Distribución profunda, aspectos biológicos y ecológicos de Aristeus Antennatus (Risso, 1816) en el Mediterráneo Occidental y Central

[EN] The object of the DESEAS Project, funded by the EC, was to gather preliminary data on the abundance and maximum depth distribution of the rose shrimp Aristeusantennatus in the Mediterranean Sea. An exploratory survey was therefore designed with that goal in mind and conducted on the R/V García del Cid, sampling the maximum depths in three specific areas in the central and western Mediterranean, one off Ibiza (Balearic Islands), one off Calabria (western Ionian Sea), and one off the southern Peloponnesian Peninsula (Gulf of Kalamata, eastern Ionian Sea). The depths sampled ranged from 600 to 4000 m, with specimens of A. antennatus being collected down to 3300 m. There were three distinct boundaries marking the abundance of this species: 1500 m, relatively low abundance (<100 ind km-2). The known population structure of this shrimp species, with increasing proportions of males and juveniles with depth, was also recorded in the deep-sea regions in other areas of the Mediterranean. No evidence of any differences in gonad development or in the presence of spermatophores carried by females was found in any of the three sampling areas. Lastly, a tendency for the relative proportion of juveniles to increase with depth was also observed[ES] El objetivo del proyecto DESEAS, financiado por la CE, fue obtener datos preliminares de abundancia y distribución de profundidad máxima de la gamba rosada Aristeus antennatus en el Mar Mediterráneo. El diseño de la campaña exploratoria fue realizado con este propósito y se desarrolló a bordo del B/O García del Cid. Se realizaron muestreos en las máximas profundidades de tres áreas específicas en el Mediterráneo occidental y central: una cerca de Menorca (Islas Baleares), otra frente a las costas de Calabria (Iónico occidental) y la última al sur de la península del Peloponeso (en el Golfo de Kalamata, Iónico oriental). Las profundidades muestreadas fueron las comprendidas entre 600 y 4000 m, obteniendo individuos de A. antennatus hasta 3300 m. Se detectaron tres niveles de abundancias diferenciados en esta especie: 1500 m, relativamente poco abundante (< 100 ind km-2). En las tres áreas estudiadas se confirmó la estructura de la población conocida hasta el momento, es decir, aumento de la proporción de machos y juveniles con la profundidad. No se encontraron evidencias de diferencias en el desarrollo gonadal o en la presencia de espermatóforos de las hembras entre áreas. Finalmente se observó la existencia de una tendencia en el aumento de la proporción de juveniles con la profundidadThis work was financially supported by the Directorate General Fisheries of the EC as part of the DESEAS survey programme (DGXIV, Study Contract, 2000/39)Peer reviewe

Inherited neuromuscular disorders: Which role for serum biomarkers?

Inherited neuromuscular disorders (INMD) are a heterogeneous group of rare diseases that involve muscles, motor neurons, peripheral nerves or the neuromuscular junction. Several different lab abnormalities have been linked to INMD: sometimes they are typical of the disorder, but they usually appear to be less specific. Sometimes serum biomarkers can point out abnormalities in presymtomatic or otherwise asymptomatic patients (e.g., carriers). More often a biomarker of INMD is evaluated by multiple clinicians other than expert in NMD before the diagnosis, because of the multisystemic involvement in INMD. The authors performed a literature search on biomarkers in inherited neuromuscular disorders to provide a practical approach to the diagnosis and the correct management of INMD. A considerable number of biomarkers have been reported that support the diagnosis of INMD, but the role of an expert clinician is crucial. Hence, the complete knowledge of such abnormalities can accelerate the diagnostic workup supporting the referral to specialists in neuromuscular disorders

Differential activity and expression of human 5β-reductase (AKR1D1) splice variants

Steroid hormones, including glucocorticoids and androgens, exert a wide variety of effects in the body across almost all tissues. The steroid A-ring 5beta-reductase (AKR1D1) is expressed in human liver and testes, and three splice variants have been identified (AKR1D1-001, AKR1D1-002, AKR1D1-006). Amongst these, AKR1D1-002 is the best described; it modulates steroid hormone availability and catalyses an important step in bile acid biosynthesis. However, specific activity and expression of AKR1D1-001 and AKR1D1-006 are unknown. Expression of AKR1D1 variants were measured in human liver biopsies and hepatoma cell lines by qPCR. Their three-dimensional (3D) structures were predicted using in silico approaches. AKR1D1 variants were over-expressed in HEK293 cells, and successful overexpression confirmed by qPCR and western blotting. Cells were treated with either cortisol, dexamethasone, prednisolone, testosterone or androstenedione, and steroid hormone clearance was measured by mass spectrometry. Glucocorticoid and androgen receptor activation were determined by luciferase reporter assays. AKR1D1-002 and AKR1D1-001 are expressed in human liver, and only AKR1D1-006 is expressed in human testes. Following over-expression, AKR1D1-001 and AKR1D1-006 protein levels were lower than AKR1D1-002, but significantly increased following treatment with the proteasomal inhibitor, MG-132. AKR1D1-002 efficiently metabolised glucocorticoids and androgens and decreased receptor activation. AKR1D1-001 and AKR1D1-006 poorly metabolised dexamethasone, but neither protein metabolised cortisol, prednisolone, testosterone or androstenedione. We have demonstrated the differential expression and role of AKR1D1 variants in steroid hormone clearance and receptor activation in vitro. AKR1D1-002 is the predominant functional protein in steroidogenic and metabolic tissues. In addition, AKR1D1-001 and AKR1D1-006 may have a limited, steroid-specific role in the regulation of dexamethasone action

Adjunctive brivaracetam and sustained seizure frequency reduction in very active focal epilepsy

Objective: This study aimed to explore the effectiveness of brivaracetam (BRV) according to baseline seizure frequency and past treatment history in subjects with focal epilepsy who were included in the Brivaracetam Add-On First Italian Network Study (BRIVAFIRST). Methods: BRIVAFIRST was a 12-month retrospective, multicenter study including adults prescribed adjunctive BRV. Study outcomes included sustained seizure response (SSR), sustained seizure freedom (SSF), and the rates of treatment discontinuation and adverse events (AEs). Baseline seizure frequency was stratified as &lt;5, 5–20, and &gt;20 seizures per month, and the number of prior antiseizure medications (ASMs) as &lt;5 and ≥6. Results: A total of 994 participants were included. During the 1-year study period, SSR was reached by 45.8%, 39.3%, and 22.6% of subjects with a baseline frequency of &lt;5, 5–20, and &gt;20 seizures per month (p &lt;.001); the corresponding figures for the SSF were 23.4%, 9.8%, and 2.8% (p &lt;.001). SSR was reached by 51.2% and 26.5% participants with a history of 1–5 and ≥6 ASMs (p &lt;.001); the corresponding rates of SSF were 24.7% and 4.5% (p &lt;.001). Treatment discontinuation due to lack of efficacy was more common in participants with &gt;20 seizures compared to those with &lt;5 seizures per month (25.8% vs. 9.3%, p &lt;.001), and in participants with history of ≥6 prior ASMs compared to those with history of 1–5 ASMs (19.6% vs. 12.2%, p =.002). There were no differences in the rates of BRV withdrawal due to AEs and the rates of AEs across the groups of participants defined according to the number of seizures at baseline and the number of prior ASMs. Significance: The baseline seizure frequency and the number of previous ASMs were predictors of sustained seizure frequency reduction with adjunctive BRV in subjects with focal epilepsy