Effects of lifestyle and genetic factors on the levels of serum adiponectin, a novel marker of the metabolic syndrome, in Finnish servicemen

Abstract Metabolic syndrome (MetS) is a combination of disorders that increase one's risk for type 2 diabetes (DM2) and cardiovascular disease (CVD). Both lifestyle and genetic factors have been established to be involved in the aetiology of MetS. Improving our knowledge about the pathophysiology of MetS could provide more effective therapeutic approaches and reduce the risk of developing DM2 and CVD. Lower levels of adiponectin, an adipose-derived protein, has been shown to be associated with the components of MetS. Common variants in a number of candidate genes related to MetS have been shown to be associated with changes in the serum adiponectin level. This study was designed to evaluate the putative effects of military lifestyle, as well as common polymorphisms of the peroxisome proliferator activated receptor gamma 2 (PPARγ2), insulin receptor substrate-1 (IRS-1) and adiponectin (APM1) genes on serum adiponectin level in a cohort of Finnish servicemen. Results of this study have showed that serum adiponectin significantly decreased during the six-month follow up in military service compared to baseline levels. This decrease was even shown in subjects that experienced a 5-10 % weight loss after six-months. Subjects with the Ala12Ala genotype of PPARγ2 had significantly higher levels of serum adiponectin compared with subjects with the Pro12Ala and Pro12Pro genotypes. Subjects having the X12Ala genotype of PPARγ2 with > 10% weight reduction showed a significant increase in serum adiponectin compared to other groups during the follow up. Those having the Ala12Ala genotype of PPARγ2 + Gly972Gly genotype of IRS-1 combination had significantly higher adiponectin compared with subjects with the Pro12Pro + Gly972Gly and Pro12Ala + Gly972Gly genotype combinations. Adiponectin levels were significantly higher in men with the T276T genotype compared with subjects with the G276T or G276G genotypes of SNP+276 of the APM1 gene. In conclusion, this study shows a possible impact of a military lifestyle as well as, candidate gene variations, and their interactions upon the regulation of serum adiponectin levels as a marker of MetS. This study could serve as a pilot for the further extensive studies with longer follow up periods as well as more accurate information on specific lifestyle factors

Rational use of medicine in the pediatric age group: A summary on the role of clinical pharmacists

Medication errors (ME) and adverse drug reactions still continue to be the important factors for out- and in-patient treatments. MEs are critical troubles in all hospitalized populations that can increase length of hospital stay, expenses, mortality and morbidity. In many countries, clinical pharmacists have been involved in reducing MEs from years ago. A growing body of evidence suggests that pharmacist interventions have major impact on reducing MEs in pediatric patients, thus improving the quality and efficiency of care provided. This paper presents a literature review on the role of clinical pharmacists in reducing MEs, and underscores the importance of pharmacist-physician-patient collaboration for all patients notably in the pediatric age group

Comparison of Epinephrine to Salbutamol in Acute Bronchiolitis

Objective: An appropriate treatment of acute viral bronchiolitis can reduce the symptoms, hospitalization duration and exorbitant costs which is imposed on the families and insurance organizations. This study was conducted to determine the efficacy of epinephrine in comparison with salbutamol in the treatment of the disease. Methods: Forty infants aged one month to 2 years with acute bronchiolitis in Amin and Al-Zahra hospitals, during 2008, were enrolled in this study. The participants were randomized in two treatment groups to receive epinephrine 0.1 ml/kg or salbutamol 0.15 mg/kg. Three doses of each medication were prescribed at intervals of 20 minutes and continued every 10 minutes after the third dose. The patients in both groups were monitored and rated by RDAI, number of the hospitalized days in the hospital, level of oxygen saturation and vital signs. Findings: Mean hospitalization duration was 3.3±1.1 and 3±0.9 in the patients receiving salbutamol and epinephrine, respectively (P=0.03). There was a significant difference in assessing RDAI index between the two groups (P=0.03). There were no differences in SPO2, PR, or RR variables in the studied intervals in both groups (P >0.05). Conclusion: Regarding the effect of epinephrine on reduction of hospitalization duration and the RDAI index in patients with acute bronchiolitis, it seems that using epinephrine instead of salbutamol could be more effective in the management of the disease