Bisphosphonate’s effect in hepatic rat cells: An electron microscopy study

Σκοπός: Τα διφωσφονικά αποτελούν εκλεκτικούς αναστολείς της οστικής απορρόφησης και η μακροχρόνια χρήση τους έχει συσχετισθεί με ανεπιθύμητες επιδράσεις στο γαστρεντερικό σύστημα. Σκοπός της εργασίας είναι η διερεύνηση των πιθανών επιδράσεων των διφωσφονικών στη δομή των ηπατικών κυττάρων. Υλικά και μέθοδος: Ελήφθησαν δείγματα ηπατικού ιστού από δέκα θηλυκά ποντίκια Wistar ηλικίας δώδεκα μηνών που έλαβαν Αλενδρονάτη από του στόματος για 13 εβδομάδες και από δέκα θηλυκά ποντίκια Wistar ηλικίας δώδεκα μηνών που δεν έλαβαν το φάρμακο και χρησιμοποιήθηκαν ως μάρτυρες. Τα δείγματα μελετήθηκαν με το ηλεκτρονικό μικροσκόπιο. Αποτελέσματα: Στα ηπατικά κύτταρα των ποντικιών που έλαβαν Αλενδρονάτη βρέθηκαν εκτεταμένη απώλεια γλυκογόνου, διαφόρου μεγέθους κενοτόπια, διευρυμένα κολπώδη τριχοειδή, καθώς και απουσία των μικρολαχνών σε πολλά σημεία του χώρου του Disse. Συμπέρασμα: Πρόκειται για την πρώτη μελέτη με ηλεκτρονικό μικροσκόπιο ηπατικών δειγμάτων μετά τη χορήγηση διφωσφονικών, η οποία υποδεικνύει ήπια ηπατική βλάβη. Μια πιθανή συσχέτιση μεταξύ της χρήσης της Αλενδρονάτης και της ηπατικής λειτουργίας καθίσταται εμφανής. Ωστόσο, εξαιτίας του μικρού αριθμού δειγμάτων περισσότερες μελέτες είναι απαραίτητες ώστε να διαλευκανθεί αυτή η συσχέτιση.Purpose: Bisphosphonates (BPs) are selective inhibitors of osteoclast mediated bone resorption, used for the treatment of bone disorders as well as for tumors, whereas long-term bisphosphonate use is associated with adverse gastrointestinal effects. The objective of the study is to investigate the possible effects of BPs in hepatic structure. Materials and methods: Specimens from the liver of ten female 12-month old Wistar rats were used as control group and of ten female 12-month old Wistar rats to which Alendronate (Fosamax, Merck) was administered per os for 13 weeks, were used as experimental group. Samples were observed under a Transmission Electron Microscope. Results: In the experimental group, extensive depletion of the glycogen, different sized vacuoles and enlarged sinusoids were found in hepatic cells. Furthermore, there was lack of microvilli of hepatocytes in the Disse’s space. The same findings were reported in all sections of the experimental group. Conclusion: This is the first study of liver structure after the administration of bisphosphonates, with electron microscopy. This report, indicate the presence of mild hepatic damage in liver tissues studied. Our study demonstrates a possible correlation between alendronate administration and hepatic cell function, nevertheless due to the small specimen further research is needed

Insulin receptor (IR) expression in human trophoblasts of recurrent pregnancy loss (RPL)

Purpose: Insulin and glucose pathways play a key role to fetal viability and growth. The focus of the study is to investigate the potential differences of immunohistochemical expression of IR in trophoblastic and decidual cells between women who had recurrent pregnancy loss and women that underwent an abortion. Materials and methods: Trophoblastic and decidual tissues from fifty (50) women with elective abortion used as control group and from fifty (50) women with recurrent miscarriages were collected during gestational weeks 6 to 12. IR antibodies were used as immunohistochemical staining markers. Nuclear and cytoplasmic expression was evaluated. Results: No IR immunohistochemical expression was detected in both trophoblastic cells of the implantation site and deciduas basalis of the two study groups. Conclusion: The effort made to enhance our knowledge on the physiology and histology of IR expression in connection with pregnancy was halted because the results were inconclusive. While studying, though, the correlation of recurrent miscarriage with IR expression, it became evident that a lot of hormones and pathways form the weave of gestational pathology and its delicate harmony. Every piece of knowledge may clarify this still obscure field

Histological Effects of Intravitreal Injection of Antifungal Agents in New Zealand White Rabbits: An Electron Microscopic and Immunohistochemical Study

Fungal endophthalmitis is a serious and vision-threatening infection which requires an immediate and effective treatment approach. Our research aims to elucidate the histological effects of the intravitreal injection of the maximum safe dosage of voriconazole and micafungin on retina. Six albino New Zealand White Rabbits were used. In experimental animals, a solution of voriconazole (Group V) or micafungin (Group M) was intravitreally injected in the right eye, while in control animals, balanced salt solution was intravitreally injected in the left eye (Group C). Euthanasia was performed ten days post injection and the retina was removed and prepared for histological examination with a light and electron microscope. Eosin-hematoxylin staining did not reveal any pathological changes in any of the samples examined. The immunohistochemical staining for Tumor Necrosis Factor alpha (TNF-a) marker was detected as negative in all samples, while Interleukin 6 (IL-6) marker was detected as mild only in the group injected with voriconazole. Electron microscopy revealed several ultrastructural alterations in retinal layers in both groups of experimental animals. Histological retinal lesions, revealed with electron microscopy in the present investigation, raises the question of the safe usage of these antifungal agents in the treatment of fungal intraocular infections in the future

Histological study of the effects of intravitreal administration of antifungal drugs to retina: experimental study

Endophthalmitis is one of the most devastating diseases in ophthalmology, often leading to partial or complete loss of vision in a short period of time, regardless of the infectious agent, which requires immediate and effective treatment. Although fungal endophthalmitis is rare in the spectrum of all intraocular infections, it remains a major clinical problem in ophthalmology due to its potentially devastating consequences. In addition, fungal ocular infections have traditionally been very difficult to treat due to the limited treatment options available both systemically and intravitrealy. In the past, Amphotericin B (AMB) was the only antifungal agent approved for intravitreal administration. However, amphotericin B has been reduced due to significant nephrotoxicity and relatively low intraocular penetration, retinal necrosis caused at low concentrations as well as the development of resistance to its action by many fungal species, necessitating the use of other antifungals with fewer side effects and probably more effective in treating fungal endophthalmitis. In fact, in recent years, there have been significant steps in the development of antifungal agents. Newer antifungal drugs have broad-spectrum antifungal activity, good bioavailability through various routes of administration, and ocular penetration. The newest representatives of these drugs studied in the present study are Voriconazole, from the class of Azoles and Micafungin, from the class of Echinocandins. A protocol was implemented using albino New Zealand rabbits. Both eyes of each animal were used. The right eyes of the animals were the study group, while the left eyes of the animals were the control group for the infusion of each drug respectively. All drugs were administered by intravitreal injection. Voriconazole solution was administered at a dose of 40 μg / 0.1ml to achieve an intravitreal concentration of 25μg / ml, while micafungin solution was administered at a dose of 25μg / 0.1ml, i.e. the highest safe dose according to the literature. More specifically, subgroups C1 and C2 were the control groups in which one and two injections of 0.1ml BSS solution were injected, respectively. Subgroups V1 and V2 were the study groups for single and double injection of voriconazole respectively. Subgroups M1 and M2 were the study groups for single and double injection of micafungin respectively. While the VM group was the study group for the combined injection of voriconazole and micafungin. The first injection was performed on day 0, the second injection on day 4 and the scheduled euthanasia of the animals was performed 10 days after the end of the intravitreal injections. An ophthalmological examination was also performed prior to the euthanasia. This was followed by the removal of the eyes and taking samples from the retinas, in order to undergo the appropriate preparation for observation under the optical microscope and the application of immunohistochemical stainings, as well as under the electron microscope. Regarding the results of the observation of the samples, voriconazole in both single and double injection protocol does not cause microscopic lesions but ultrastructural lesions. In fact, with one injection, lesions are found in the nerve fiber layer, in the ganglion cell layer and in the outer nuclear layer, while with two injections, more severe lesions are found in the aforementioned layers as well as additionally in the inner nuclear layer and in the layer of rods and cones. Micafungin in a single injection protocol does not cause microscopic lesions, while the two injections protocol causes lesions in the ganglion cell layer. However, ultrastructural lesions in almost all retinal layers are found in all specimens with both single and double micafungin injections, and in fact with the double injection’s lesions being more extensive and pronounced than the ones of the single injection. Co-administration of voriconazole and micafungin caused both microscopic and ultrastructural lesions in almost all layers, especially in the ganglion cell layer and the layer of rods and cones. Regarding the immunohistochemical staining for marker TNF-a, it was negative in all subgroups except the eyes with the combined infusion of voriconazole and micafungin in which it was detected as mildly positive in the presence of apoptotic cells in the ganglion cell layer in 2 of the 3 eyes of the subgroup. Regarding the staining for marker IL-6, it was negative in all subgroups except the eyes with a single injection of voriconazole in which it was detected as mildly positive in all samples. In conclusion, voriconazole appears to be more toxic in a multi-dose protocol. The immunohistochemical marker TNF-a does not seem to play a pathogenetic role in the lesions caused by voriconazole in the retina. On the contrary, the conclusions regarding the role of IL-6-mediated inflammation in causing retinal lesions by voriconazole are contradictory. As for micafungin, it is toxic to the retina and based on the extent and intensity of its caused lesions it seems to be more toxic than voriconazole. However, the TNF-a and IL-6 immunohistochemical markers do not appear to play a pathogenetic role in micafungin-induced retinal lesions. Finally, toxic effect on the retina caused by the combination of the two antifungal agents was found with TNF-a-mediated apoptosis appearing to belong to the mechanisms of retinal damage caused by the combined administration of voriconazole and micafungin. In contrast, IL-6-mediated inflammation does not appear to contribute to retinal lesions caused by the combined administration of the two agents.Η ενδοφθαλμίτιδα αποτελεί μια από τις πιο καταστροφικές παθήσεις στην οφθαλμολογία οδηγώντας συχνά σε μερική ή πλήρη απώλεια της όρασης μέσα σε σύντομο χρονικό διάστημα, ασχέτως του λοιμογόνου παράγοντα, γεγονός που απαιτεί άμεση και αποτελεσματική θεραπευτική προσέγγιση. Αν και η μυκητιασική ενδοφθαλμίτιδα είναι σπάνια στο σύνολο των ενδοφθάλμιων λοιμώξεων, παραμένει ένα σημαντικό κλινικό πρόβλημα στην οφθαλμολογία λόγω των δυνητικά καταστροφικών συνεπειών της. Επιπρόσθετα, οι οφθαλμικές λοιμώξεις από μύκητες ήταν παραδοσιακά πολύ δύσκολο να αντιμετωπιστούν λόγω των περιορισμένων θεραπευτικών επιλογών που υπήρχαν τόσο συστηματικά όσο και ενδοϋαλοειδικά. Στο παρελθόν, η Αμφοτερικίνη Β (AMB) αποτελούσε το μοναδικό αντιμυκητιακό παράγοντα με έγκριση για ενδοϋαλοειδική χορήγηση. Ωστόσο, η αμφοτερικίνη Β έχει περιοριστεί λόγω της σημαντικής νεφροτοξικότητας και της σχετικά χαμηλής ενδοφθάλμιας διείσδυσης, της αμφιβληστροειδικής νέκρωσης που προκαλεί σε χαμηλές συγκεντρώσεις καθώς και της ανάπτυξης αντίστασης στη δράση της από πολλά είδη μυκήτων, με αποτέλεσμα να δημιουργηθεί η ανάγκη χρήσης άλλων αντιμυκητιακών παραγόντων με λιγότερες ανεπιθύμητες ενέργειες και πιθανότατα με μεγαλύτερη αποτελεσματικότητα στη θεραπεία των μυκητιασικών ενδοφθαλμίτιδων. Μάλιστα, τα τελευταία χρόνια, υπήρξαν σημαντικά βήματα στην ανάπτυξη αντιμυκητιακών παραγόντων. Τα νεότερα αντιμυκητιακά φάρμακα έχουν αντιμυκητιακή δράση ευρέος φάσματος, καλή βιοδιαθεσιμότητα με διάφορες οδούς χορήγησης και οφθαλμική διείσδυση. Οι νεότεροι εκπρόσωποι αυτών των φαρμάκων που μελετήθηκαν στην παρούσα έρευνα είναι η Βορικοναζόλη, από την τάξη των Αζολών και η Μικαφουγκίνη, από την τάξη των Εχινοκανδινών. Υλοποιήθηκε πρωτόκολλο με χρήση κονίκλων albino New Zealand. Στους κονίκλους χρησιμοποιήθηκαν και οι δυο οφθαλμοί κάθε ζώου. Οι δεξιοί οφθαλμοί των ζώων αποτέλεσαν την ομάδα μελέτης, ενώ οι αριστεροί οφθαλμοί των ζώων αποτέλεσαν την ομάδα ελέγχου για την έγχυση του κάθε φαρμάκου αντίστοιχα. Όλα τα φάρμακα χορηγήθηκαν με ενδοϋαλοειδική έγχυση. Το διάλυμα βορικοναζόλης χορηγήθηκε σε δόση 40 μg/0.1ml για επίτευξη ενδοϋαλοειδικής συγκέντρωσης 25μg/ml, ενώ το διάλυμα μικαφουγκίνης χορηγήθηκε σε δόση 25μg/0.1ml, δηλαδή στην υψηλότερη ασφαλή δοσολογία σύμφωνα με τη βιβλιογραφία. Αναλυτικότερα, οι υποομάδες C1 και C2 αποτέλεσαν την ομάδα ελέγχου και σε αυτές χορηγήθηκαν μία και δύο εγχύσεις 0.1ml διαλύματος BSS, αντίστοιχα. Οι υποομάδες V1 και V2 αποτέλεσαν την ομάδα μελέτης για τη μονή και διπλή έγχυση βορικοναζόλης αντίστοιχα. Οι υποομάδες Μ1 και Μ2 αποτέλεσαν την ομάδα μελέτης για τη μονή και διπλή έγχυση μικαφουγκίνης αντίστοιχα. Ενώ η ομάδα VM αποτέλεσε την ομάδα μελέτης για τη συνδυαστική έγχυση βορικοναζόλης και μικαφουγκίνης. Η πρώτη ένεση πραγματοποιήθηκε την ημέρα 0, η δεύτερη ένεση την ημέρα 4 και η προγραμματισμένη θανάτωση των ζώων πραγματοποιήθηκε 10 ημέρες μετά το πέρας των ενδοϋαλοειδικών ενέσεων. Επίσης, προ της θανάτωσης πραγματοποιήθηκε οφθαλμολογικός έλεγχος. Ακολούθησε η αφαίρεση των οφθαλμών και η λήψη δειγμάτων από τους αμφιβληστροειδείς, ώστε να υποστούν την κατάλληλη επεξεργασία για παρατήρηση στο οπτικό μικροσκόπιο και για χρώσεις ανοσοϊστοχημείας, καθώς και στο ηλεκτρονικό μικροσκόπιο. Όσον αφορά τα αποτελέσματα της παρατήρησης των δειγμάτων, η βορικοναζόλη τόσο σε πρωτόκολλο μίας όσο και διπλής έγχυσης δεν προκαλεί μικροσκοπικές αλλοιώσεις αλλά υπερμικροσκοπικές αλλοιώσεις. Μάλιστα, με τη μία έγχυση ανευρίσκονται βλάβες στη στιβάδα των νευρικών ινών, στη στιβάδα των γαγγλιακών κυττάρων και στην έξω κοκκώδη στιβάδα, ενώ με τις δύο εγχύσεις ανευρίσκονται πιο έντονες βλάβες στις προαναφερθείσες στιβάδες καθώς και επιπρόσθετα βλάβες τόσο στην έσω κοκκώδη στιβάδα όσο και στη στιβάδα των ραβδίων και των κωνίων. Η μικαφουγκίνη σε πρωτόκολλο μίας έγχυσης δεν προκαλεί μικροσκοπικές αλλοιώσεις σε αντίθεση με τις δύο εγχύσεις της που προκαλούν αλλοιώσεις στη στιβάδα των γαγγλιακών κυττάρων. Ωστόσο, υπερμικροσκοπικές αλλοιώσεις σχεδόν σε όλες τις στιβάδες του αμφιβληστροειδούς ανευρίσκονται σε όλα τα δείγματα τόσο με τη μία όσο και με τις δύο εγχύσεις μικαφουγκίνης, και μάλιστα με τις αλλοιώσεις στη διπλή έγχυση να είναι πιο εκτεταμένες και έντονες σε σχέση με τη μία έγχυση μικαφουγκίνης. Στη συνδυαστική χορήγηση βορικοναζόλης και μικαφουγκίνης ανευρέθηκαν τόσο μικροσκοπικές όσο και υπερμικροσκοπικές αλλοιώσεις σχεδόν σε όλες τις στιβάδες και ιδιαίτερα στη στιβάδα των γαγγλιακών κυττάρων και των φωτοϋποδοχέων. Όσον αφορά την ανοσοϊστοχημική χρώση για τον δείκτη TNF-a, ήταν αρνητική σε όλες τις υποομάδες εκτός από τους οφθαλμούς με τη συνδυαστική έγχυση βορικοναζόλης και μικαφουγκίνης όπου ανιχνεύθηκε ως ήπια θετική με την παρουσία κυττάρων σε απόπτωση στη στιβάδα των γαγγλιακών κυττάρων στους 2 από τις 3 οφθαλμούς της ομάδας. Όσον αφορά τη χρώση για το δείκτη IL-6, ήταν αρνητική σε όλες τις υποομάδες εκτός από τους οφθαλμούς με μία έγχυση βορικοναζόλης όπου ανιχνεύτηκε ως ήπια θετική σε όλα τα δείγματα. Συμπερασματικά, η βορικοναζόλη φαίνεται πως είναι περισσότερο τοξική σε πρωτόκολλο περισσότερων δόσεων. O ανοσοϊστοχημικός δείκτης ΤNF-a δεν φαίνεται να διαδραματίζει παθογενετικό ρόλο στις αλλοιώσεις που προκαλεί η βορικοναζόλη στον αμφιβληστροειδή. Αντίθετα, αντικρουόμενα είναι τα συμπεράσματα όσον αφορά το ρόλο της διαμεσολαβούμενης από την IL-6 φλεγμονής στην πρόκληση αλλοιώσεων στον αμφιβληστροειδή από τη βορικοναζόλη. Όσον αφορά τη μικαφουγκίνη, είναι τοξική επί του αμφιβληστροειδούς και μάλιστα βάσει της έκτασης και της έντασης των ευρημάτων της φαίνεται ότι είναι πιο τοξική σε σχέση με τη βορικοναζόλη. Ωστόσο, οι ανοσοϊστοχημικοί δείκτες ΤNF-a και IL-6 δεν φαίνεται να διαδραματίζουν παθογενετικό ρόλο στις αλλοιώσεις που προκαλεί η μικαφουγκίνη στον αμφιβληστροειδή. Τέλος, ανευρέθηκε τοξική δράση επί του αμφιβληστροειδούς του συνδυαστικού σχήματος χορήγησης με την TNF-a διαμεσολαβούμενη απόπτωση να φαίνεται πως ανήκει στους μηχανισμούς της αμφιβληστροειδικής βλάβης που προκαλείται από τη συνδυαστική χορήγηση της βορικοναζόλης και της μικαφουγκίνης. Αντίθετα, η διαμεσολαβούμενη από την IL-6 φλεγμονή δε φαίνεται πως συμβάλλει στην πρόκληση αλλοιώσεων στον αμφιβληστροειδή από συνδυαστική χορήγηση των δύο παραγόντων

Management of Harlequin Ichthyosis: A Brief Review of the Recent Literature

Harlequin ichthyosis (HI) is a life-threatening genetic disorder that largely affects the skin of infants. HI is the most severe form of the autosomal recessive disorder known as ichthyosis. It is caused by mutations in the A12 cassette (lipid-transporter adenosine triphosphate-binding cassette A12). Neonates affected by this disease are born with specific morphological characteristics, the most prominent of which is the appearance of platelet keratotic scales separated by erythematous fissures. The facial features include eclabium, ectropion, a distinct flattened nose, and dysplastic ears. A common finding among those with HI is impaired skin barrier function. The purpose of the present narrative review is to assess the most recent literature regarding the management of HI. Emphasis is given to surgical management and consultation, to the indications for timing and surgical intervention, to the risks that are presented with surgery, and to the details of the surgical procedure itself. Management of HI requires a multidisciplinary team of experts, and specific guidelines are needed in order for the risks to be minimized and viability to be increased

Genetic and Epigenetic Factors Associated with Postpartum Psychosis: A 5-Year Systematic Review

Purpose: Postpartum psychosis (PPP) is a serious mental health illness affecting women post-parturition. Around 1 in 1000 women are affected by postpartum psychosis, and the symptoms usually appear within 2 weeks after birth. Postpartum mental disorders are classified into 3 main categories starting from the least to most severe types, including baby blues, postpartum depression, and postpartum psychosis. Materials and Methods: In this systematic review, genetic and epigenetic factors associated with postpartum psychosis are discussed. A PRISMA flow diagram was followed, and the following databases were used as main sources: PubMed, ScienceDirect, and Scopus. Additional information was retrieved from external sources and organizations. The time period for the articles extracted was 5 years. Results: Initially, a total of 2379 articled were found. After the stated criteria were applied, 58 articles were identified along with 20 articles from additional sources, which were then narrowed down to a final total of 29 articles. Conclusions: It can be concluded that there is an association between PPP and genetic and epigenetic risk factors. However, based on the data retrieved and examined, the association was found to be greater for genetic factors. Additionally, the presence of bipolar disorder and disruption of the circadian cycle played a crucial role in the development of PPP

Stress, Anxiety and Depression Prevalence among Greek University Students during COVID-19 Pandemic: A Two-Year Survey

Background: The negative effect of COVID-19 pandemic on college students’ mental health is well-demonstrated. The aim of this study is to assess the impact of the pandemic on the students of Aristotle University of Thessaloniki (Northern Greece), in terms of stress, anxiety, and depression, and to analyze the probable correlation of various social and phycological factors. Methods: The survey was conducted in the form of a questionnaire, which was first distributed in November 2020 and then re-launched in November 2021. The evaluation was carried out through the DASS21 screening tool. Associations regarding participants’ characteristics and the three variables (stress, anxiety, and depression) were investigated with Pearson’s chi-squared (Χ2) test. Results: The first-year results (November 2020) revealed severe prevalence of stress, anxiety, and depression (37.4%, 27.2% and 47% respectively). The second-year results (November 2021) revealed a significant augmentation in all three variables, mainly for the extreme severe scales (47.3%, 41.1% and 55% respectively). Participants who were receiving psychiatric treatment exhibited higher levels of stress, anxiety, and depression, especially during the second year of the pandemic (p-Value p-Value < 0.00001). Conclusions: The community of Aristotle University of Thessaloniki has been greatly affected during the last 2 years. The inherent risks of the confinement measures on students’ well-being and mental health are undeniable. Recurrent annual psychological evaluation in universities and colleges is strongly advised

Immunohistochemical Evaluation of CD3, CD4, CD8, and CD20 in Decidual and Trophoblastic Tissue Specimens of Patients with Recurrent Pregnancy Loss

Recurrent miscarriages affect up to 5% of couples. CD3+ (T-lymphocytes), CD4+ (helper T-lymphocytes), CD8+ (cytotoxic T-lymphocytes), and CD20+ (B-lymphocytes) cells may participate in the pathophysiology of recurrent pregnancy loss (RPL). The aim of this study was to investigate the complicity of these molecules in RPL. The experimental specimens were obtained from 20 females who underwent miscarriages in the first gestational trimester, while the control group&rsquo;s specimens consisted of 20 females who proceeded with voluntary pregnancy termination during the same period. Tissue samples were taken from the decidua basalis, decidua parietalis, and trophoblast (placental chorionic villi) and were studied using immunohistochemical methods. Monoclonal antibodies were used against CD3, CD4, CD8, and CD20 cells. The lymphocyte levels in the decidua parietalis displayed profound disparities among the two groups. The decidua basalis and trophoblast exhibited almost the same disparities regarding positive CD cells. The comparison of CD4+ and CD8+ cells in the endometrial tissue revealed a significant difference between the two groups of study. The analysis uncovered a strong relationship between RPL and the presence of CD3+, CD4+, CD8+, and CD20+ cells in the decidua parietalis tissue. The number of positive T cells was decreased in the decidual basalis and chorionic villi, proving that their absence significantly disrupts the balance of the immunological environment

Renal Injuries after Cardiac Arrest: A Morphological Ultrastructural Study

Background: This study aims to investigate the probable lesions and injuries induced in the renal tissue after a cardiac arrest. The renal ischemia–reperfusion model in cardiac arrest describes the effects of ischemia in the kidneys, alongside a whole-body ischemia–reperfusion injury. This protocol excludes ischemic conditions caused by surgical vascular manipulation, venous injury or venous congestion. Methods: For the experimental study, 24 swine were subjected to cardiac arrest. Seven minutes later, the cardiopulmonary resuscitation technique was performed for 5 min. Afterwards, advanced life support was provided. The resuscitated swine consisted one group and the non-resuscitated the other. Tissue samples were obtained from both groups for light and electron microscopy evaluation. Results: Tissue lesions were observed in the tubules, parallel to destruction of the microvilli, reduction in the basal membrane invaginations, enlarged mitochondria, cellular vacuolization, cellular apoptosis and disorganization. In addition, fusion of the podocytes, destruction of the Bowman’s capsule parietal epithelium and abnormal peripheral urinary space was observed. The damage appeared more extensive in the non-resuscitated swine group. Conclusions: Acute kidney injury is not the leading cause of death after cardiac arrest. However, evidence suggests that the kidney damage after a cardiac arrest should be highly considered in the prognosis of the patients’ health outcome

Antidiabetic Drugs in the Treatment of Alzheimer&rsquo;s Disease

The public health burden of type 2 diabetes mellitus and Alzheimer&rsquo;s disease is steadily increasing worldwide, especially in the population of older adults. Epidemiological and clinical studies suggest a possible shared pathophysiology between the two diseases and an increased risk of AD in patients with type 2 diabetes mellitus. Therefore, in recent years, there has been a substantial interest in identifying the mechanisms of action of antidiabetic drugs and their potential use in Alzheimer&rsquo;s disease. Human studies in patients with mild cognitive impairment and Alzheimer&rsquo;s disease have shown that administration of some antidiabetic medications, such as intranasal insulin, metformin, incretins, and thiazolidinediones, can improve cognition and memory. This review aims to examine the latest evidence on antidiabetic medications as a potential candidate for the treatment of Alzheimer&rsquo;s disease