Undetectable high-performance liquid chromatography haemoglobin A1c on variant haemoglobin E phenotype: a case report

The gold standard for long-term monitoring of diabetic patients is glycated haemoglobin (HbA1c), which is routinely tested for glycaemic control. Furthermore, the National glycohemoglobin standardization program (NGSP) has designated high-performance liquid chromatography (HPLC) as the reference method for HbA1c measurement. A woman from the Sumba tribe, Indonesia, aged 52, visited the Internal Medicine Clinic for a routine check-up. She had been taking diabetic and hypertension medicines on a regular basis for over 10 years. The HPLC procedure yielded “no result” for the patient’s HbA1c assessment and there was no peak on the HPLC graphic. However, there was a discrepancy between the data history of HbA1c measured by turbidimetric method (average of 51 mmol/mol, reference range < 48 mmol/mol), fasting blood glucose (average of 7.7 mmol/L, reference range < 7.0 mmol/L) and 2-hour plasma glucose (average of 13 mmol/L, reference range < 11.1 mmol/L). Glycated albumin was 3.1 mmol/L (reference range 1.8-2.4 mmol/L). Haemoglobin electrophoresis identified homozygote haemoglobinopathy E (HbE). Patients with haemoglobin variants are proposed to utilize glycated albumin

Analysis of Adrenocorticotropic Hormone and Cortisol Levels in Acute Respiratory Distress Syndrome COVID-19 Patients

Objective. SARS-CoV-2 infection may cause multiple organ failure. However, scarce information can be found on the impact on the endocrine system. This study was conducted to determine plasma Adrenocorticotropic hormone (ACTH) and plasma cortisol levels in a cohort of COVID-19 patients with Acute Respiratory Distress Syndrome (ARDS). Methods. A prospective cohort study was conducted on COVID-19 patients who manifested ARDS and were admitted to the ICU of Dr. Soetomo Tertiary Hospital, Surabaya, Indonesia. Morning plasma ACTH and plasma total cortisol were measured on 45 recruited patients. The outcome of the patient was justified based on the survivance on days 7th and 30th during the follow-up with groupings of surviving for survived patients and nonsurvive for deceased patients. Results. The ACTH and cortisol median were 1.06 (0.5–64.57) pg/mL and 17.61 (0.78–75) μg/dL, respectively. Both parameters were assembled to allow the allocation of the 45 subjects into the survive and nonsurvive groups. There was a moderate correlation between ACTH and cortisol levels in all groups (, ) and particularly ACTH and cortisol levels in COVID-19 patients who survived on the 7th-day and 30th-day follow-up ( and , respectively, with ). It is important to note that there was no correlation for an individual parameter, either ACTH only or cortisol only, compared to the outcome among patients with various comorbid. Conclusion. ACTH or cortisol alone has no correlation to the outcome of these patients. Therefore, further study of the potential use of corticosteroid treatments guided by ACTH and cortisol levels in reducing the risk of ARDS warrants further investigation

Acetylcholine synthesis, storage, degredation and nicotinic receptores in a rat model for space-induced muscle atrophy

Space flight results in loss of mass and function in skeletal muscle. Data from manned flights and animal biosatellites give evidence of possible changes in neuromuscular interactions. Components at the neuromuscular junction are a potential site of action for this space-induced muscle atrophy. We examined the nicotinic acetylcholine receptor population (Bmax) and affinity (Kd), the activity of choline acetyltransferase (ChAT) and acetylcholinesterase (AChE), and the endogenous levels of acetylcholine (ACh) and choline (Ch). We assayed the hindlimb soleus, gastrocnemius and tibialis, and the forelimb triceps brachii muscles after 1, 3 or 8 weeks of supsension. Bmax was greater than controls in the triceps brachii and in the gastrocnemius after 3 and 8 weeks of suspension respectively. Receptor Kd was decreased in the soleus muscles of rats suspended for 3 weeks. Enzyme activity decreased from control animals' levels in all 4 muscles, with the time to effect varying depending on the muscle and the enzyme. No difference was found in endogenous ACh levels in the soleus, but levels were increased in the gastrocnemius (3 weeks), and decreased in the tibialis (3 weeks) and triceps brachii (1 week). Ch levels were decreased in the soleus (1 and 3 weeks) and gastrocnemius (3 weeks) with no change from control levels in the tibialis and triceps brachii. Testosterone, as an anabolic hormone to skeletal muscle, was assayed in suspended and control rats. We found no difference from control animals in total testes tissue levels. Plasma levels were increased in suspended animals after 8 weeks

Intususcepción por complicación de gastrostomía

Introducción: La oclusión intestinal constituye la segunda causa de abdomen agudo quirúrgico y el 20 % de los ingresos en los servicios de urgencia; algunas revisiones muestran que se producen cada año más de 9000 muertes por esta causa. Objetivo: Presentar un paciente oncológico al cual se le realizó una gastrostomía y posteriormente se complicó con una intususcepción. Caso clínico: Paciente de 59 años de edad, al cual se le realizó una gastrostomía alimentaria al presentar disfagia. Días más tarde el paciente se complicó con una oclusión intestinal y falleció en un corto periodo. Conclusiones: La intususcepción es una enfermedad infrecuente en adultos, con una presentación clínica poco específica. Los síntomas cardinales son el dolor de tipo cólico, vómitos, distención abdominal y detención del tránsito intestinal

Age-Dependent Variability in Gene Expression in Male Fischer 344 Rat Retina

Recent evidence suggests that older adults may be a sensitive population with regard to environmental exposure to toxic compounds. One source of this sensitivity could be an enhanced variability in response. Studies on phenotypic differences have suggested that variation in response does increase with age. However, few reports address the question of variation in gene expression as an underlying cause for increased variability of phenotypic response in the aged. In this study, we utilized global analysis to compare variation in constitutive gene expression in the retinae of young (4 months), middle-aged (11 months), and aged (23 months) Fischer 344 rats. Three hundred and forty transcripts were identified in which variance in expression increased from 4 to 23 months of age, while only 12 transcripts were found for which it decreased. Functional roles for identified genes were clustered in basic biological categories including cell communication, function, metabolism, and response to stimuli. Our data suggest that population stochastically induced variability should be considered in assessing sensitivity due to old age

Atypical microglial response to biodiesel exhaust in healthy and hypertensive rats

Accumulating evidence suggests a deleterious role for urban air pollution in central nervous system (CNS) diseases and neurodevelopmental disorders. Microglia, the resident innate immune cells and sentinels in the brain, are a common source of neuroinflammation and are implicated in how air pollution may exert CNS effects. While renewable energy, such as soy-based biofuel, is of increasing public interest, there is little information on how soy biofuel may affect the brain. To address this, male spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto (WKY) rats were exposed to 100% Soy Biodiesel Exhaust (100SBDE; 0, 50, 150 and 500 μg/m3) by inhalation for 4 h/day for 4 weeks (5 days/week). IBA-1 staining of microglia in the substantia nigra revealed significant changes in morphology with 100SBDE exposure in rats from both genotypes, where the SHR were less sensitive. Further analysis failed to show consistent changes in pro-inflammatory cytokine expression, nitrated protein, and arginase1 expression in brain tissue from either rat strain exposed to 100SBDE. CX3CR1 and fractalkine mRNA expression were lower in the striatum of all 100SBDE exposed rats, but greater SBDE exposure was required for loss of fractalkine expression in the SHR. Together, these data support that month-long 100SBDE exposure impacts the basal ganglia with changes in microglia morphology, an impaired fractalkine axis, and an atypical activation response without traditional markers of M1 or M2 activation, where the SHR may be less sensitive to these effects

Caracterización de pacientes operados por obstrucción intestinal mecánica

Introducción: En Cuba, la oclusión intestinal mecánica es una de las causas más frecuentes de abdomen agudo y constituye la segunda causa de cirugía de urgencia. Objetivo: Caracterizar una serie de pacientes intervenidos quirúrgicamente, con diagnóstico de obstrucción intestinal mecánica. Métodos: Se realizó un estudio observacional descriptivo transversal en sujetos atendidos durante el año 2022 en el servicio de cirugía general del Hospital Docente Clínico - Quirúrgico "Miguel Enríquez". Se estudiaron 81 pacientes; se recogieron las variables sexo, edad, antecedentes patológicos personales, hábitos tóxicos, estadía hospitalaria, causa de la oclusión intestinal, complicaciones y estado al egreso. Se realizó análisis de frecuencias. Resultados: Hubo mayor porcentaje del sexo femenino (50,6 %), de las edades comprendidas de 31 a 40 años (23,5 %), los pacientes con hipertensión arterial (14,8 %) y los fumadores (18,5 %). La causa más frecuente de oclusión fueron las bridas y adherencias (44,4 %) y la complicación más frecuente fue la bronconeumonía (8 %). Falleció solo el 3,7 % de los pacientes. Conclusiones: Los pacientes se caracterizaron por estar entre la tercera y cuarta décadas de la vida, con predominio del sexo femenino, con antecedentes de salud, sin hábitos tóxicos, con estadía hospitalaria entre 1 y 5 días, presencia de bridas y adherencias como causa de la obstrucción y baja frecuencia de complicaciones y fallecimientos

Developmental Exposure to a Commercial PBDE Mixture: Effects on Protein Networks in the Cerebellum and Hippocampus of Rats

Background: Polybrominated diphenyl ethers (PBDEs) are structurally similar to polychlorinated biphenyls (PCBs) and have both central (learning and memory deficits) and peripheral (motor dysfunction) neurotoxic effects at concentrations/doses similar to those of PCBs. The cellular and molecular mechanisms for these neurotoxic effects are not fully understood; however, several studies have shown that PBDEs affect thyroid hormones, cause oxidative stress, and disrupt Ca2+-mediated signal transduction. Changes in these signal transduction pathways can lead to differential gene regulation with subsequent changes in protein expression, which can affect the development and function of the nervous system