Single-centre experience on endocardial and epicardial pacemaker system function in neonates and infants

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Long-term oral L-arginine administration improves peripheral and hepatic insulin sensitivity in type 2 diabetic patients

WSTĘP. Celem badania była ocena wpływu przewlekłego doustnego stosowania L-argininy, działającej przez normalizację szlaku NO/cykliczny 3’,5’-guanozyno monofosforan (cGMP), na poprawę insulinowrażliwości obwodowej i wątrobowej u 12 szczupłych osób chorych na cukrzycę typu 2. MATERIAŁ I METODY. Badanie, przeprowadzone metodą podwójnie ślepej próby, trwało 3 miesiące. W pierwszym miesiącu chorych leczono typową dietą cukrzycową. Następnie losowo przydzielono ich do dwóch grup. W grupie 1 przez 2 miesiące stosowano typową dietę i placebo (doustnie 3 × d.). W grupie 2 pacjentów leczono przez miesiąc dietą i placebo (doustnie 3 × d.) i następnie przez miesiąc dietą i L-argininą (3 g 3 × d.). Po pierwszymi i drugim miesiącu wykonano badanie za pomocą klamry euglikemiczno-hiperinsulinemicznej z jednoczesnym wlewem dożylnym znakowanej izotopowo glukozy (glukoza 6,6- 2H2). Grupą kontrolną stanowiło 10 zdrowych osób, u których również wykonano badanie za pomocą klamry. WYNIKI. W grupie 1 w czasie badania nie zaobserwowano zmian podstawowego stężenia cGMP, skurczowego ciśnienia tętniczego, przepływu krwi w przedramieniu, wykorzystania glukozy i endogennej produkcji glukozy. W grupie 2 przyjmowanie L-argininy spowodowało normalizację podstawowego stężenia cGMP, poprawę przepływu w przedramieniu o 36%, oraz wykorzystania glukozy w badaniu metodą klamry metabolicznej o 34%, jak również obniżenie skurczowego ciśnienia tętniczego i endogennej produkcji glukozy odpowiednio o 14 i 29%. Pomimo tego w porównaniu z grupą kontrolną podawanie L-argininy nie normalizuje całkowicie metabolizmu glukozy. WNIOSKI. Podawanie L-argininy u chorych na cukrzycę typu 2 znacznie poprawia insulinowrażliwość obwodową i wątrobową, lecz nie normalizuje jej całkowicie.INTRODUCTION. The aim of this study was to evaluate whether long-term administration of L-arginine acting through a normalization of NO/cyclic-guanosine- 3’,5’-cyclic monophosphate (cGMP) pathway was able to ameliorate peripheral and hepatic insulin sensitivity in 12 lean type 2 diabetic patients. MATERIAL AND METHODS. A double-blind study was performed for 3 months. In the first month, patients were treated with their usual diet. Then they were randomly allocated into two groups. In group 1, patients were treated with diet plus placebo (orally three times per day) for 2 months. In group 2 patients were treated for 1 month with diet plus placebo (orally, three times per day) and then for 1 month with diet plus L-arginine (3 g three times per day). At the end of the first and the second month of therapy, patients underwent a euglycemic-hyperinsulinemic clamp combined with [6,6-2H2] glucose infusion. A total of 10 normal subjects underwent the same test as control subjects. RESULTS. In group 1, no changes in basal cGMP levels, systolic blood pressure, forearm blood flow, glucose disposal, and endogenous glucose production were observed throughout. In group 2, L-arginine normalized basal cGMP levels and significantly increased forearm blood flow by 36% and glucose disposal during the clamp by 34%, whereas it decreased systolic blood pressure, and endogenous glucose production by 14 and 29%, respectively. However, compared with normal subjects, L-arginine treatment was not able to completely overcome the defect in glucose disposal. CONCLUSIONS. L-arginine treatment significantly improves but does not completely normalize peripheral and hepatic insulin sensitivity in type 2 diabetic patients

CARTA DELLE ACQUE TERMALI E MINERALI DELLA REGIONE CAMPANIA

CARTA TEMATIC

Shape of the OGTT glucose curve and risk of impaired glucose metabolism in the EGIR-RISC cohort

Objective. To study whether the shape of the oral glucose tolerance test (OGTT)-glucose curve is a stable trait over time; it is associated with differences in insulin sensitivity, beta-cell function and risk of impaired fasting glucose (IFG) and glucose tolerance (IGT) in the Relationship between Insulin Sensitivity and Cardiovascular Disease (RISC) cohort. Methods. OGTT-glucose curve shape was classified as monophasic, biphasic, triphasic and anomalous in 915 individuals. Oral glucose insulin sensitivity (OGIS), Matsuda insulin sensitivity index (ISI) and beta-cell function were assessed at baseline and 3 years apart. Results. The OGTT-glucose curve had the same baseline shape after 3 years in 540 people (59%; kappa = 0.115; p < 0.0001). Seventy percent of the participants presented with monophasic OGTT-glucose curve shape at baseline and after 3 years (percent positive agreement 0.74). Baseline monophasic shape was associated with significant increased risk of IFG (OR 1.514; 95% CI 1.084-2.116; p = 0.015); biphasic shape with reduced risk of IGT (OR 0.539; 95% CI 0.310-0.936) and triphasic shape with reduced risk of IFG (OR 0.493; 95% CI 0.228-1.066; P = 0.043) after 3 years. Increased risks of IFG (OR 1.509; 95% CI 1.008-2.260; p = 0.05) and IGT (OR 1.947; 95% CI 1.085-3.494; p = 0.02) were found in people who kept stable monophasic morphology over time and in switchers from biphasic to monophasic shape (OR of IGT = 3.085; 95% CI 1.377-6.912; p = 0.001). Conclusion. After 3 years follow-up, the OGTT-glucose shape was stable in 59% of the RISC cohort. Shapes were associated with different OGIS and beta-cell function; persistence over time of the monophasic shape and switch from biphasic to monophasic shape with increased risk of impaired glucose metabolism. (C) 2017 Elsevier Inc. All rights reserved

Elevated heart rate predicts β cell function in non-diabetic individuals: the RISC cohort

Elevated heart rate has been associated with insulin resistance and incident type 2 diabetes but its relationship with B-cell function is not known. Our aim was to investigate whether baseline heart rate is associated wirth B-cell function and hyperlgycaemia

Molecular Characterization of Integrons in Epidemiologically Unrelated Clinical Isolates of Acinetobacter baumannii from Italian Hospitals Reveals a Limited Diversity of Gene Cassette Arrays

Integron carriage by 36 epidemiologically unrelated Acinetobacter baumannii isolates collected over an 11-year period from patients in six different Italian hospitals was investigated. Sixteen type 1 integron-positive isolates (44%) were found, 13 of which carried the same array of cassettes, i.e., aacC1, orfX, orfX′, and aadA1a. As ribotype analysis of the isolates demonstrated a notable genetic diversity, horizontal transfer of the entire integron structure or ancient acquisition was hypothesized

Shape of the OGTT glucose curve and risk of impaired glucose metabolism in the EGIR-RISC cohort

Objective To study whether the shape of the oral glucose tolerance test (OGTT)-glucose curve is a stable trait over time; it is associated with differences in insulin sensitivity, f-cell function and risk of impaired fasting glucose (IFG) and glucose tolerance (IGT) in the Relationship between Insulin Sensitivity and Cardiovascular Disease (RISC) cohort. Methods OGTT-glucose curve shape was classified as monophasic, biphasic, triphasic and anomalous in 915 individuals. Oral glucose insulin sensitivity (OGIS), Matsuda insulin sensitivity index (ISI) and f-cell function were assessed at baseline and 3\ua0years apart. Results The OGTT-glucose curve had the same baseline shape after 3\ua0years in 540 people (59%; \u3ba\ua0=\ua00.115; p\ua0<\ua00.0001). Seventy percent of the participants presented with monophasic OGTT-glucose curve shape at baseline and after 3\ua0years (percent positive agreement 0.74). Baseline monophasic shape was associated with significant increased risk of IFG (OR 1.514; 95% CI 1.084\u20132.116; p\ua0=\ua00.015); biphasic shape with reduced risk of IGT (OR 0.539; 95% CI 0.310\u20130.936) and triphasic shape with reduced risk of IFG (OR 0.493; 95% CI 0.228\u20131.066; P\ua0=\ua00.043) after 3\ua0years. Increased risks of IFG (OR 1.509; 95% CI 1.008\u20132.260; p\ua0=\ua00.05) and IGT (OR 1.947; 95% CI 1.085\u20133.494; p\ua0=\ua00.02) were found in people who kept stable monophasic morphology over time and in switchers from biphasic to monophasic shape (OR of IGT\ua0=\ua03.085; 95% CI 1.377\u20136.912; p\ua0=\ua00.001). Conclusion After 3\ua0years follow-up, the OGTT-glucose shape was stable in 59% of the RISC cohort. Shapes were associated with different OGIS and f-cell function; persistence over time of the monophasic shape and switch from biphasic to monophasic shape with increased risk of impaired glucose metabolism

Endemic Carbapenem-resistant Pseudomonas aeruginosa with Acquired Metallo-β-lactamase Determinants in European Hospital

Acquired metallo-β-lactamases (MBLs) can confer broad-spectrum β-lactam resistance (including carbapenems) not reversible by conventional β-lactamase inhibitors and are emerging resistance determinants of remarkable clinical importance. In 2001, multidrug-resistant Pseudomonas aeruginosa carrying blaVIM MBL genes were found to be widespread (approximately 20% of all P. aeruginosa isolates and 70% of the carbapenem-resistant isolates) at Trieste University Hospital. Clonal diversity and heterogeneity of resistance determinants (either blaVIM-1-like or blaVIM-2-like) were detected among MBL producers. This evidence is the first that acquired MBLs can rapidly emerge and establish a condition of endemicity in certain epidemiologic settings