Growth hormone and its relationship to the microvascular complications of diabetes mellitus

The aim of this work was to discover possible causes of growth hormone (GH) hypersecretion in diabetic subjects, and to examine the possibility that the GH so produced is relevant to the development of diabetic microvascular disease. To reassess the hypothesis that GH plays a role in the genesis of diabetic microvascular complications, patients who had undergone pituitary ablation for treatment of retinopathy were followed up. Between 1960 and 1976, 117 patients had an pituitary implant. The 5 year mortality of these patients was 17.6% and the 10 year 51%, figures lower than generally reported for patients with proliferative retinopathy. Between 7 and 13% developed renal failure post-ablation, again lower than generally reported for unablated diabetics. The 100 patients operated on between 1965 and 1976 were included in the ophthalmological follow-up. Of these patients, the visual acuity in the better eye at the time of operation was 6/12 or more in 84%, this percentage remaining similar at the time of 5 and 10 year follow-up. By 5 years, grading of new vessels on the disc had improved from an initial grading of 2.7+1.6 to 0.8+1.2 (mean+SD, p<0.001), and by 10 years there was no disc neovascularisation in any eye. There was similar improvement in peripheral new vessels, hard exudates, microaneurysms and haemorrhages. It is concluded that pituitary ablation had a beneficial effect on the course of diabetic microvascular complications. After brief confirmation of the fact that GH hypersecretion can be demonstrated in patients with retinopathy using the 'in house' GH radioimmunoassay, an investigation of aspects of the GH regulatory pathways in normal and diabetic subjects was carried out to suggest potential causes of GH hypersecretion in diabetes. rising growth hormone releasing factor (1-44) (GRF), it is demonstrated that hyperglycaemia leads to a suppression of GRF stimulated GH secretion in normal subjects. Only 3 of 6 diabetic subjects studied in a similar fashion demonstrated suppression. In pituitary cells in culture, neither glucose nor insulin produced any effect on GRF stimulated GH secretion. It is concluded that hyperglycaemia produces suppression of GH by its action at hypothalamic level, and it can be inferred that there is a defect in GH regulation at this level in diabetes, perhaps mediated by lack of, or resistance to, somatostatin. Regarding the mechanism of GH hypersecretion in diabetes, 3 possible mechanisms are identified - somatostatin resistance induced by chronic hyperglycaemia, GH release induced by fluctuating plasma glucose, and failure of IGF-I generation secondary to poor glycaemic control. Regarding the role of GH and IGF-I in the genesis of diabetic microvascular complications, it is concluded that there is presently insufficient evidence to assign a specific role for either GH or IGF-I

Usefulness of applying research reporting guidelines as Writing Aid software : a crossover randomised controlled trial

Objectives: To assess the intention of using a Writing Aid software, which integrates four research reporting guidelines (Consolidated Standards of Reporting Trials, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Strengthening the Reporting of Observational Studies in Epidemiology and STrengthening the Reporting of Observational Studies in Epidemiology-nutritional epidemiology) and their Elaboration & Explanation (E&E) documents during the write-up of research in Microsoft Word compared with current practices. Design: Two-arms crossover randomised controlled trial with no blinding and no washout period. Setting: Face-to-face or online sessions. Participants: 54 (28 in arm 1 and 26 in arm 2) doctoral arid postdoctoral researchers. Interventions: Reporting guidelines and their E&E document were randomly administered as Writing Aid or as Word documents in a single 30 min to 1 hour session, with a short break before crossing over to the other study intervention. Primary and secondary outcomes: Using the Technology Acceptance Model, we assessed the primary outcome: the difference in the mean of intention of use; and secondary outcomes: the difference in mean perceived ease of use and perceived usefulness. The three outcomes were measured using questions with a 7-point Likert-scale. Secondary analysis using structural equation modelling (SEM) was applied to explore the relationships between the outcomes. Results: No significant difference in reported intention of use (mean difference and 95% CI 0.25 (-0.05 to 0.55), p=0.10), and perceived usefulness (mean difference and 95% CI 0.19 (-0.04 to 0.41), p=0.10). The Writing Aid performed significantly better than the word document on researchers' perceived ease of use (mean difference and 95% CI 0.59 (0.29 to 0.89), p<0.001). In the SEM analysis, participants' intention of using the tools was indirectly affected by perceived ease of use (beta 0.53 p=0.002). Conclusions: Despite no significant difference in the intention of use between the tools, administering reporting guidelines as Writing Aid is perceived as easier to use, offering a possibility to further explore its applicability to enhance reporting adherence

An unusual case of finger swelling: A case report

A 66 year old man initially presented with haemoptysis and subsequently required a pneumonectomy for a lung mass, following this he had a finger swelling which was found to be a rare leiomyosarcoma and this was a metastatic deposit. This pattern of metastasis for this type of tumour has not been described before

Improving treatment outcomes for adolescents with borderline personality disorder through a socioecological approach

Background There is a dearth of studies evaluating treatment efficacy for adolescents diagnosed with borderline personality disorder. The few available randomized controlled trials that have been conducted show modest results and treatments appear to have equivalent effects. The current paper draws on (a) the lessons learnt from the last 50 years of psychotherapy research in general and (b) recent advances in mentalization-based understanding of why treatment works, which together point to the importance of following a socioecological approach in the treatment of personality problems in adolescence – a developmental period that insists on a treatment approach that goes beyond the therapist-client dyad. Case presentation Here, we describe such an approach, and offer a clinical case example with a young 16-year old girl diagnosed with borderline personality disorder, to illustrate what a shift toward a more socioecological approach would entail. Conclusions The clinical impact of the socioecological approach and the potential benefits as illustrated in the current case illustration, offers a framework that justifies and allows for the expansion of service delivery for youth with borderline personality disorder beyond dyadic therapist-client work

Mouse Anesthesia: The Art and Science

There is an art and science to performing mouse anesthesia, which is a significant component to animal research. Frequently, anesthesia is one vital step of many over the course of a research project spanning weeks, months, or beyond. It is critical to perform anesthesia according to the approved research protocol using appropriately handled and administered pharmaceutical-grade compounds whenever possible. Sufficient documentation of the anesthetic event and procedure should also be performed to meet the legal, ethical, and research reproducibility obligations. However, this regulatory and documentation process may lead to the use of a few possibly oversimplified anesthetic protocols used for mouse procedures and anesthesia. Although a frequently used anesthetic protocol may work perfectly for each mouse anesthetized, sometimes unexpected complications will arise, and quick adjustments to the anesthetic depth and support provided will be required. As an old saying goes, anesthesia is 99% boredom and 1% sheer terror. The purpose of this review article is to discuss the science of mouse anesthesia together with the art of applying these anesthetic techniques to provide readers with the knowledge needed for successful anesthetic procedures. The authors include experiences in mouse inhalant and injectable anesthesia, peri-anesthetic monitoring, specific procedures, and treating common complications. This article utilizes key points for easy access of important messages and authors\u27 recommendation based on the authors\u27 clinical experiences

Parvovirus 4 Infection and Clinical Outcome in High-Risk Populations

Parvovirus 4 (PARV4) is a DNA virus frequently associated with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections, but its clinical significance is unknown. We studied the prevalence of PARV4 antibodies in 2 cohorts of HIV- and HCV-infected individuals (n = 469) and the correlations with disease status. We found that PARV4 infection frequently occurred in individuals exposed to bloodborne viruses (95% in HCV-HIV coinfected intravenous drug users [IDUs]). There were no correlations between PARV4 serostatus and HCV outcomes. There was, however, a significant association with early HIV-related symptoms, although because this was tightly linked to both HCV status and clinical group (IDU), the specific role of PARV4 is not yet clear

Parvovirus 4 Infection and Clinical Outcome in High-Risk Populations

Parvovirus 4 (PARV4) is a DNA virus frequently associated with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections, but its clinical significance is unknown. We studied the prevalence of PARV4 antibodies in 2 cohorts of HIV- and HCV-infected individuals (n=469) and the correlations with disease status. We found that PARV4 infection frequently occurred in individuals exposed to bloodborne viruses (95% in HCV-HIV coinfected intravenous drug users [IDUs]). There were no correlations between PARV4 serostatus and HCV outcomes. There was, however, a significant association with early HIV-related symptoms, although because this was tightly linked to both HCV status and clinical group (IDU), the specific role of PARV4 is not yet clea

DYNAMO-I. A sample of Ha-luminous galaxies with resolved kinematics

DYNAMO is a multiwavelength, spatially resolved survey of local (z ~ 0.1) star-forming galaxies designed to study evolution through comparison with samples at z ≃ 2. Half of the sample has integrated Hα luminosities of >1042 erg s-1, the typical lo

Factors associated with Anaplasma spp. seroprevalence among dogs in the United States

Background Dogs in the United States are hosts to a diverse range of ticks and tick-borne pathogens, including A. phagocytophilum, an important emerging canine and human pathogen. Previously, a Companion Animal Parasite Council (CAPC)-sponsored workshop proposed factors purported to be associated with the infection risk for tick-transmitted pathogens in dogs in the United States, including climate conditions, socioeconomic characteristics, local topography, and vector distribution. Methods Approximately four million test results from routine veterinary diagnostic tests from 2011–2013, which were collected on a county level across the contiguous United States, are statistically analyzed with the proposed factors via logistic regression and generalized estimating equations. Spatial prevalence maps of baseline Anaplasma spp. prevalence are constructed from Kriging and head-banging smoothing methods. Results All of the examined factors, with the exception of surface water coverage, were significantly associated with Anaplasma spp. prevalence. Overall, Anaplasma spp. prevalence increases with increasing precipitation and forestation coverage and decreases with increasing temperature, population density, relative humidity, and elevation. Interestingly, socioeconomic status and deer/vehicle collisions were positively and negatively correlated with canine Anaplasma seroprevalence, respectively. A spatial map of the canine Anaplasma hazard is an auxiliary product of the analysis. Anaplasma spp. prevalence is highest in New England and the Upper Midwest. Conclusions The results from the two posited statistical models (one that contains an endemic areas assumption and one that does not) are in general agreement, with the major difference being that the endemic areas model estimates a larger prevalence in Western Texas, New Mexico, and Colorado. As A. phagocytophilum is zoonotic, the results of this analysis could also help predict areas of high risk for human exposure to this pathogen

High star formation rates as the origin of turbulence in early and modern disk galaxies

High spatial and spectral resolution observations of star formation and kinematics in early galaxies have shown that two-thirds are massive rotating disk galaxies with the remainder being less massive non-rotating objects. The line of sight averaged velocity dispersions are typically five times higher than in today's disk galaxies. This has suggested that gravitationally-unstable, gas-rich disks in the early Universe are fuelled by cold, dense accreting gas flowing along cosmic filaments and penetrating hot galactic gas halos. However these accreting flows have not been observed, and cosmic accretion cannot power the observed level of turbulence. Here we report on a new sample of rare high-velocity-dispersion disk galaxies we have discovered in the nearby Universe where cold accretion is unlikely to drive their high star-formation rates. We find that the velocity dispersion is most fundamentally correlated with their star-formation rates, and not their mass nor gas fraction, which leads to a new picture where star formation itself is the energetic driver of galaxy disk turbulence at all cosmic epochs.Comment: 9 pages, 2 figures, Supplimentary Info available at: http://pulsar.swin.edu.au/~agreen/nature/sigma_mean_arXiv.pdf. Accepted for publication in Natur