Assessment of depression in diabetic patients

Background: Diabetes is one of the most common chronic conditions in the world. The worldwide prevalence of diabetes mellitus (DM) has risen dramatically over the past two decades because of increasing obesity and reduced activity levels. The purpose of this study was to show the association between depression and diabetes. Methods: It was a cross-study. The study included 240 patients who were chosen randomly with no gender bias. A convenient subject of 240 diabetic patients was interviewed. Results: Out of the total 240 diabetic patients, included in this study, the majority of patients, 52.63% in the age group of 60 years had depression with a Hamilton score of >19 while 47.37% of patients in the age of 40 to 50 years had Hamilton score of >19. 84.21% of males had depression with a Hamilton score >19 as compared to females who had a Hamilton score of 15.79%. The patients within the age group of 40-59 have 2.5 times more risk of having depression as compared to the age group of 20 to 39 and patients in the age group >60 years have 4.23 times higher risk of depression as compared to patients in the age group of 20 to 39 years. The association between gender and depression shows that males have a higher rate of depression (78.17%) as compared to females (21.81%) with an odd's ratio of 3.0. Conclusions: Our study showed a high prevalence of depression and anxiety in male patients and the elderly age group. Planning and implementation of screening for mental health issues in the elderly population diagnosed with a lifestyle disease-such as type 2 diabetes mellitus-with existing comorbidities should be recognized as one of the most important goals of the public health system. It seems necessary to involve medical teams in the screening process to verify the symptoms, promptly establish the diagnosis, and initiate the appropriate depression treatment. In diabetic patients, depression remains underdiagnosed and an important aspect of the diabetic specialists would be the awareness of this quite common co-morbidity

Severe androgenetic alopecia as a maker of metabolic syndrome in male patients of androgenetic alopecia: a hospital based case control study

Background: Several previous studies have investigated the association between androgenetic alopecia (AGA) and metabolic syndrome (MS), with inconsistent results. Objectives of the study were to study the prevalence of metabolic syndrome in male patients of androgenetic alopecia and compare with control population and study the relationship of metabolic syndrome with different grades of AGA.Methods: This prospective hospital based case control study included 100 new clinically diagnosed males of androgenetic alopecia, and age and sex matched control group. Assessment for presence of various components of metabolic syndrome was done following a uniform protocol in cases and controls. AGA was classified as per Hamilton –Narwood classification, grade I to III was classified as mild –moderate and grade IV and higher as severe AGA.Results: Of the 100 male AGA patients (age range 21-50, mean 34.49), 36 had grade II AGA, 24 had grade III AGA, 20 had grade IV AGA, 15 had grade V AGA and 5 had grade VI AGA. Among AGA patients, 60 of patients had mild-moderate AGA and 40 patients had severe AGA. Metabolic syndrome was statistically significantly more common in patients with AGA compared to controls. Among patients of AGA, metabolic syndrome was statistically significantly present in severe AGA compared to mild-moderate AGA. Among the evaluated parameters, like blood pressure, fasting blood sugar, dyslipedemia, abdominal obesity, all were significantly more common in AGA patients compared to controls except abdominal obesity.Conclusions: In the present study, metabolic syndrome was found to be 4.6 times more common in patients of androgenetic alopecia as compared to controls, being statistically significant, and more common in those with severe grades. This suggests that androgenetic alopecia patients especially with severe grades are at risk of metabolic syndrome and other cardiovascular diseases

Patterns in the spectral composition of sunlight and biologically meaningful spectral photon ratios as affected by atmospheric factors

Plants rely on spectral cues present in their surroundings, generated by the constantly changing light environment, to guide their growth and reproduction. Photoreceptors mediate the capture of information by plants from the light environment over a wide range of wavelengths, but despite extensive evidence that plants respond to various light cues, only fragmentary data have been published showing patterns of diurnal, seasonal and geographical variation in the spectral composition of daylight. To illustrate patterns in spectral photon ratios, we measured time series of irradiance spectra at two distinct geographical and climatological locations, Helsinki, Finland and Gual Pahari, India. We investigated the drivers behind variation of the spectral photon ratios measured at these two locations, based on the analysis of over 400 000 recorded spectra. Differences in spectral irradiance were explained by different atmospheric factors identified through multiple regression model analysis and comparison to spectral irradiance at ground level simulated with a radiative transfer model. Local seasonal and diurnal changes in spectral photon ratios were related to solar elevation angle, atmospheric water-vapour content and total ozone column thickness and deviated from their long-term averages to an extent likely to affect plant photobiology. We suggest that future studies should investigate possible effects of varying photon ratios on terrestrial plants. Solar elevation angle especially affects the patterns of B:G and B:R ratios. Water vapour has a large effect on the R:FR photon ratio and modelled climate scenarios predict that increasing global temperatures will result in increased atmospheric water vapour. The development of proxy models, utilising available data from weather and climate models, for relevant photon ratios as a function of solar elevation angle and atmospheric factors would facilitate the interpretation of results from past, present and future field studies of plants and vegetation.Peer reviewe

Prescription opioid use before and after kidney transplant: Implications for posttransplant outcomes

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146648/1/AJT14714-sup-0001-AppendixS1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146648/2/ajt14714_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146648/3/ajt14714.pd

Astrocyte-derived Wnt growth factors are required for endothelial blood-brain barrier maintenance

Maintenance of the endothelial blood-brain-barrier (BBB) through Wnt/β-catenin signalling is essential for neuronal function. The cells however, providing Wnt growth factors at the adult neurovascular unit (NVU) are poorly explored. Here we show by conditionally knocking out the evenness interrupted (Evi) gene in astrocytes (Evi(ΔAC)) that astrocytic Wnt release is crucial for BBB and NVU integrity. Evi(ΔAC) mice developed brain oedema and increased vascular tracer leakage. While brain vascularization and endothelial junctions were not altered in 10 and 40 week-old mice, endothelial caveolin(Cav)-1-mediated vesicle formation was increased in vivo and in vitro. Moreover, astrocytic end-feet were swollen, and aquaporin-4 distribution was disturbed, coinciding with decreased astrocytic Wnt activity. Vascular permeability correlated with increased neuronal activation by c-fos staining, indicative of altered neuronal function. Astrocyte-derived Wnts thus serve to maintain Wnt/β-catenin activity in endothelia and in astrocytes, thereby controlling Cav-1 expression, vesicular abundance, and end-feet integrity at the NVU

p53 Target Gene SMAR1 Is Dysregulated in Breast Cancer: Its Role in Cancer Cell Migration and Invasion

Tumor suppressor SMAR1 interacts and stabilizes p53 through phosphorylation at its serine-15 residue. We show that SMAR1 transcription is regulated by p53 through its response element present in the SMAR1 promoter. Upon Doxorubicin induced DNA damage, acetylated p53 is recruited on SMAR1 promoter that allows activation of its transcription. Once SMAR1 is induced, cell cycle arrest is observed that is correlated to increased phospho-ser-15-p53 and decreased p53 acetylation. Further we demonstrate that SMAR1 expression is drastically reduced during advancement of human breast cancer. This was correlated with defective p53 expression in breast cancer where acetylated p53 is sequestered into the heterochromatin region and become inaccessible to activate SMAR1 promoter. In a recent report we have shown that SMAR1 represses Cyclin D1 transcription through recruitment of HDAC1 dependent repressor complex at the MAR site of Cyclin D1 promoter. Here we show that downmodulation of SMAR1 in high grade breast carcinoma is correlated with upregulated Cyclin D1 expression. We also established that SMAR1 inhibits tumor cell migration and metastases through inhibition of TGFβ signaling and its downstream target genes including cutl1 and various focal adhesion molecules. Thus, we report that SMAR1 plays a central role in coordinating p53 and TGFβ pathways in human breast cancer

World Heart Federation Roadmap for Digital Health in Cardiology.

More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability and affordability of CVD medicine, and service delivery. Digital health technologies can help address these challenges. They may be a tool to reach Sustainable Development Goal 3.4 and reduce premature mortality from non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation. World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them