Is treatment of type 1 diabetes mellitus (insulin therapy, metabolic control) optimal for preventing cardiovascular autonomic neuropathy?

Introduction: Long-term poor metabolic control promotes the occurrence of microvascular complications, such as cardiovascular autonomic neuropathy (CAN) and atherogenic hyperlipidaemia, which translates into increased mortality in patients with type 1 diabetes mellitus (T1DM). The aim of the study was to assess the prevalence of CAN in patients with T1DM in relation to treatment method (continuous subcutaneous insulin infusion, CSII, versus multiple daily injections using pens, MDI) and metabolic control. Material and methods: The study group comprised 93 adults (60 women, 33 men), mean age 31 years, with T1DM being treated at a local clinical centre from 2011 to 2015. The presence of CAN, the results of laboratory tests, and anthropometric data were analysed. The subjects were divided into two groups according to treatment method (CSII, MDI). Results: The median duration of diabetes was 16 years. 61% of the subjects used MDI and 39% used CSII. 41% of the subjects presented with CAN (confirmed with the Ewing test using ProSciCard apparatus), with a significantly lower prevalence in the group of patients treated with CSII (15.4% vs. 60.4%; p < 0.001). The mean HbA1c level in the CSII-treated group was noticeably lower (7.44 ± 1.67% vs. 8.55 ± 1.1%, p < 0.001), and these patients also had lower triglyceride levels (0.71 vs. 1.32 mmol/L, p < 0.001). Regardless of the treatment method, 72% of all patients under 40 years of age achieved their therapeutic target of LDL cholesterol level < 2.6 mmol/L, whereas only 13% of all those over 40 years old achieved an LDL cholesterol level < 1.8 mmol/L. Conclusions: The presented results draw attention to the high prevalence of CAN among T1DM patients. The study reveals the need for more intensive monitoring and treatment of hyperlipidaemia, despite good glycaemic control, especially in those over the age of 40 years.

Neurological symptoms in hospitalised patients with COVID-19 and their association with in-hospital mortality

Objectives. To evaluate the spectrum of neurological symptoms in patients with COVID-19 during the first 14 days of hospitalisation and its association with in-hospital mortality. Material and methods. We included 200 patients with RT-PCR-confirmed COVID-19 admitted to University Hospital in Krakow, Poland. In 164 patients, a detailed questionnaire concerning neurological symptoms and signs was performed prospectively within 14 days of hospitalisation. In the remaining 36 patients, such questionnaires were completed retrospectively based on daily observations in the Department of Neurology. Results. During hospitalisation, 169 patients (84.5%) experienced neurological symptoms; the most common were: fatigue (62.5%), decreased mood (45.5%), myalgia (43.5%), and muscle weakness (42.5%). Patients who died during hospitalisation compared to the remainder were older (79 [70.5–88.5] vs. 63.5 [51–77] years, p = 0.001), and more often had decreased level of consciousness (50.0% vs. 9.3%, p < 0.001), delirium (33.3% vs. 4.4%, p < 0.001), arterial hypotension (50.0% vs. 19.6%, p = 0.005) or stroke during (18.8% vs. 3.3%, p = 0.026) or before hospitalisation (50.0% vs. 7.1, p < 0.001), whereas those who survived more often suffered from headache (42.1% vs. 0%, p = 0.012) or decreased mood (51.7% vs. 0%, p = 0.003). Conclusions. Most hospitalised patients with COVID-19 experience neurological symptoms. Decreased level of consciousness, delirium, arterial hypotension, and stroke during or before hospitalisation increase the risk of in-hospital mortality

MiRNA Expression in Patients with Gaucher Disease Treated with Enzyme Replacement Therapy

Aims: The aim of the work was to establish potential biomarkers or drug targets by analysing changes in miRNA concentration among patients with Gaucher disease (GD) compared to in healthy subjects. Methods: This study was an observational, cross-sectional analysis of 30 adult participants: 10 controls and 20 adults with GD type 1. Patients with GD type 1 were treated with enzyme replacement therapy (ERT) for at least two years. The control group was composed of healthy volunteers, unrelated to the patients, adjusted with age, sex and body mass index (BMI). The miRNA alteration between these groups was examined. After obtaining preliminary results on a group of six GD patients by the high-output method (TaqMan low-density array (TLDA)), potential miRNAs were selected for confirming the results by using the qRT-PCR method. With Diane Tools, we analysed miRNAs of which differential expression is most significant and their potential role in GD pathophysiology. We also determined the essential pathways these miRNAs are involved in. Results: 266 dysregulated miRNAs were found among 753 tested. Seventy-eight miRNAs were downregulated, and 188 were upregulated. Thirty miRNAs were significantly altered; all of them were upregulated. The analysis of pathways regulated by the selected miRNAs showed an effect on bone development, inflammation or regulation of axonal transmission in association with Parkinson’s disease. Conclusions: We revealed few miRNAs, like miR-26-5p, which are highly altered and fit the GD pathophysiological model, might be considered as novel biomarkers of disease progression but need further evaluation

The Role of NF-κB in Endometrial Diseases in Humans and Animals: A Review

The expression of genes of various proinflammatory chemokines and cytokines is controlled, among others, by the signaling pathway of the nuclear factor kappaB (NF-κB) superfamily of proteins, providing an impact on immune system functioning. The present review addresses the influence and role of the NF-κB pathway in the development and progression of most vital endometrial diseases in human and animal species. Immune modulation by NF-κB in endometritis, endometrosis, endometriosis, and carcinoma results in changes in cell migration, proliferation, and inflammation intensity in both the stroma and epithelium. In endometrial cells, the NF-κB signaling pathway may be activated by multiple stimuli, such as bacterial parts, cytokines, or hormones binding to specific receptors. The dysregulation of the immune system in response to NF-κB involves aberrant production of chemokines and cytokines, which plays a role in endometritis, endometriosis, endometrosis, and endometrial carcinoma. However, estrogen and progesterone influence on the reproductive tract always plays a major role in its regulation. Thus, sex hormones cannot be overlooked in endometrial disease physiopathology. While immune system dysregulation seems to be NF-κB-dependent, the hormone-independent and hormone-dependent regulation of NF-κB signaling in the endometrium should be considered in future studies. Future goals in this research should be a step up into clinical trials with compounds affecting NF-κB as treatment for endometrial diseases

Characteristics of the Donkey’s Dorsal Profile in Relation to Its Functional Body Condition Assessment

As the breeding of donkeys has increased due to different types of use, welfare evaluation importance increases. This equid’s welfare state has been described using body condition indicators and the geometric morphometrics method. However, the dorsal profile has not yet been assessed in donkeys. In this study, the body condition score (BCS), fatty neck score (FNS), dental condition score (DCS), sex, and breed were used as criteria of dorsal profile deformations. Photographs of 40 donkeys were analyzed using geometric morphometrics. Within the entire set of dorsal profiles, the variance of the first three principal components (PCs) was PC1 = 37.41%, PC2 = 23.43%, and PC3 = 13.34%. The dorsal profiles displayed deformation as an effect of FNS and BCS on size (FNS p = 0.012; BCS p = 0.024) and shape (FNS p < 0.0001; BCS p < 0.0001), rather than as an effect of DCS (p < 0.0001), sex (p = 0.0264), and breed (p < 0.0001) only on shape. The highest distances among the categories (Mahalanobis distances: MD ≥ 13.26; Procrustes distances: PD ≥ 0.044) were noted for FNS. The lowest distances were noted between jennets and males (MD = 4.58; PD = 0.012) and between BCS 1 and BCS 2 (MD = 4.70; PD = 0.018). Donkeys’ body condition affects their dorsal profile and both FNS and BCS measurements should be considered when a donkey’s dorsal profile is investigated

Comparison of Donkey, Pony, and Horse Dorsal Profiles and Head Shapes Using Geometric Morphometrics

Since donkey breeding has increased due to their variety of uses, welfare evaluation has become more important. This study aimed to compare donkey, pony, and horse dorsal profiles and head shapes using geometric morphometrics (GM). Photographs of 14 donkeys, 14 ponies, and 14 horses were analyzed using GM, including the sliding semilandmarks method. The variations in the first three principal components (PCs) were PC1: 57.16%, PC2: 16.05%, and PC3: 8.31% for the dorsal profiles and PC1: 44.77%, PC2: 13.46%, and PC3: 7.66% for the head shapes. Both the dorsal profiles and head shapes differed between donkeys and horses (p p > 0.05). Moreover, both the dorsal profiles and head shapes differed in size between ponies and horses (p p > 0.05). Higher Mahalanobis and Procrustes distances were noted between donkeys and horses as well between donkeys and ponies than between ponies and horses. The use of geometric morphometrics revealed the differences in the dorsal profiles and head shapes between the studied equids. These differences should be taken into account when adapting welfare scales and methods from horses to donkeys