The question of differential diagnosis of anemia in diabetes mellitus

BACKGROUND: High prevalence of anemia in diabetes mellitus (DM) determines the relevance of studying its pathogenetic aspects, the role of anemia in DM complications development and the issue of differential diagnosis between iron deficiency anemia (IDA) and anemia of chronic disease (ACD)).AIM: To establish the diagnostic value of classical parameters for diagnosing anemia in DM and propose an optimized algorithm for the differential diagnosis of ACD and IDA in DM type 1 and 2 using new markers.MATERIALS AND METHODS: The observational, single-centre, comparative, controlled, single-stage study. Patients underwent assessment of glycated hemoglobin, creatinine, microalbuminuria; indicators of iron metabolism — hematocrit, the number of erythrocytes, reticulocytes, hemoglobin, serum iron, transferrin, ferritin, the level of soluble transferrin receptors (sTfR), sTfR/logFerpitin index, and inflammation markers — erythrocyte sedimentation rate (ESR), leukocyte count, high sensitive CRP and TNF-α. ROC-analysis was used to assess the differential diagnosis markers informative content.RESULTS: We examined 135 patients: 51 with DM 1 and 84 with DM 2. The patients were stratified into groups based on anemia type: 1) ACD 2) IDA 3) latent iron deficiency 4) without ferrokinetics disorders. According to the ROC-analysis in DM patients, the following parameters had high information content in ACD. ESR — sensitivity 92%, specificity 85%, diagnostic threshold 26.5 mm/h (area under the curve (AUC) 0.943; p<0.0001); leukocyte count — sensitivity 69%, specificity 64%, diagnostic threshold 7.50x109/l (AUC 0.727; p=0.007), microalbuminuria — sensitivity 71%, specificity 72%, diagnostic threshold 29.5 mg/l (AUC 0.744; p=0.003). In DM sTfR and the sTfR /logFerritin index had high information content in IDA at diagnostic thresholds different from those for general population. The sensitivity of sTfR 71%, the specificity 71%, diagnostic threshold 1.42 ng/mL (2.9 ng/mL for general population) (AUC 0.765; p=0.024). The sensitivity of sTfR/logFerritin index 100%, the specificity 97%, diagnostic threshold 1.48 (2.0 for general population) (AUC 0.983; p=0.024).CONCLUSION: In differential diagnosis of IDA and ACD in DM, ESR, leukocyte count, microalbuminuria, sTfR and sTfR/logFerritin index have a high diagnostic value. This allows proposing them as additional markers for differential diagnosis of anemia in DM

Optically induced forces and torques:Interactions between nanoparticles in a laser beam

Distinctive optical forces and torques arise between nanoparticles irradiated by intense laser radiation. These forces, associated with a pairwise process of stimulated scattering, prove to enable the possibility of producing significant modifications to both the form and magnitude of interparticle forces, with additional contributions arising in the case of dipolar materials. Moreover, such forces have the capacity to generate unusual patterns of nanoscale response, entirely controlled by the input beam characteristics- principally the optical frequency, intensity, and polarization. Based on quantum electrodynamical theory, a general result is secured for the laser-induced force under arbitrary conditions, incorporating both static and dynamic coupling mechanisms. Specific features of the results are identified for pairs of particles with prolate cylindrical symmetry, e.g., carbon nanotubes, where it is shown that the laser-induced forces and torques are sensitive functions of the pair spacing and orientation, and the laser beam geometry; significantly, they can be either repulsive or attractive according to conditions. For nanoparticles trapped in a Laguerre-Gaussian laser beam the results also reveal additional and highly distinctive torques that suggest further possibilities for nanomanipulation with light. The paper concludes with a discussion on several potential applications of such forces. © 2005 The American Physical Society

Dynamics in nonlocal linear models in the Friedmann-Robertson-Walker metric

A general class of cosmological models driven by a nonlocal scalar field inspired by the string field theory is studied. Using the fact that the considering linear nonlocal model is equivalent to an infinite number of local models we have found an exact special solution of the nonlocal Friedmann equations. This solution describes a monotonically increasing Universe with the phantom dark energy.Comment: 18 pages, 3 figures, a few misprints in Section 5 have been correcte

Dynamics with Infinitely Many Derivatives: The Initial Value Problem

Differential equations of infinite order are an increasingly important class of equations in theoretical physics. Such equations are ubiquitous in string field theory and have recently attracted considerable interest also from cosmologists. Though these equations have been studied in the classical mathematical literature, it appears that the physics community is largely unaware of the relevant formalism. Of particular importance is the fate of the initial value problem. Under what circumstances do infinite order differential equations possess a well-defined initial value problem and how many initial data are required? In this paper we study the initial value problem for infinite order differential equations in the mathematical framework of the formal operator calculus, with analytic initial data. This formalism allows us to handle simultaneously a wide array of different nonlocal equations within a single framework and also admits a transparent physical interpretation. We show that differential equations of infinite order do not generically admit infinitely many initial data. Rather, each pole of the propagator contributes two initial data to the final solution. Though it is possible to find differential equations of infinite order which admit well-defined initial value problem with only two initial data, neither the dynamical equations of p-adic string theory nor string field theory seem to belong to this class. However, both theories can be rendered ghost-free by suitable definition of the action of the formal pseudo-differential operator. This prescription restricts the theory to frequencies within some contour in the complex plane and hence may be thought of as a sort of ultra-violet cut-off.Comment: 40 pages, no figures. Added comments concerning fractional operators and the implications of restricting the contour of integration. Typos correcte

Non-local SFT Tachyon and Cosmology

Cosmological scenarios built upon the generalized non-local String Field Theory and $p$-adic tachyons are examined. A general kinetic operator involving an infinite number of derivatives is studied as well as arbitrary parameter $p$. The late time dynamics of just the tachyon around the non-perturbative vacuum is shown to leave the cosmology trivial. A late time behavior of the tachyon and the scale factor of the FRW metric in the presence of the cosmological constant or a perfect fluid with $w>-1$ is constructed explicitly and a possibility of non-vanishing oscillations of the total effective state parameter around the phantom divide is proven.Comment: 17 pages, LaTeX; v2: JHEP3 class is used, references adde

Large Nongaussianity from Nonlocal Inflation

We study the possibility of obtaining large nongaussian signatures in the Cosmic Microwave Background in a general class of single-field nonlocal hill-top inflation models. We estimate the nonlinearity parameter f_{NL} which characterizes nongaussianity in such models and show that large nongaussianity is possible. For the recently proposed p-adic inflation model we find that f_{NL} ~ 120 when the string coupling is order unity. We show that large nongaussianity is also possible in a toy model with an action similar to those which arise in string field theory.Comment: 27 pages, no figures. Added references and some clarifying remark

Bouncing and Accelerating Solutions in Nonlocal Stringy Models

A general class of cosmological models driven by a non-local scalar field inspired by string field theories is studied. In particular cases the scalar field is a string dilaton or a string tachyon. A distinguished feature of these models is a crossing of the phantom divide. We reveal the nature of this phenomena showing that it is caused by an equivalence of the initial non-local model to a model with an infinite number of local fields some of which are ghosts. Deformations of the model that admit exact solutions are constructed. These deformations contain locking potentials that stabilize solutions. Bouncing and accelerating solutions are presented.Comment: Minor corrections, references added, published in JHE

Роль цитокинов в патогенезе аутоиммунного диабета, вопросы иммуноинтервенции

The review devotes to studying the role of cytokines in development of autoimmune diabetes mellitus, latent autoimmune diabetes in adults included. Therapeutic approaches to prevent the loss of endogenous insulin secretion are discussed. There is review of clinical trials of immunosuppressive agents and modulators of immune tolerance in autoimmune diabetes mellitus.Рассмотрена роль цитокинов в патогенезе аутоиммунного сахарного диабета, включая латентный аутоиммунный диабет взрослых. Обсуждаются терапевтические подходы, направленные на предупреждение снижения секреции эндогенного инсулина. Приведен обзор клинических испытаний иммуносупрессивных средств и модуляторов иммунологической толерантности при аутоиммунном сахарном диабете (типа 1А)

К вопросу о дифференциальной диагностике анемического синдрома у беременных

The review is dedicated to the diagnostics of hypochromic microcytic anemia among pregnant women with carbohydrate metabolism disorders by means of existing laboratory algorithm of examination. We give some data on the anemic syndrome in women with diabetes mellitus type 1. These data demonstrate an equal occurrence of anemia of chronic disorder and iron-deficiency anemia in this group of patients. Special attention is paid to the role of hepcidin in iron metabolism as well as to the mechanisms of regulation of hepcidin production under normal and pathological conditions. The review cites researches, which demonstrate the effectiveness of hepcidin measurement for differential diagnostics of anemic syndrome. We also touch upon the problem concerning treatment of anemia of chronic disorder.В обзоре раскрывается проблема дифференциальной диагностики микроцитарных гипохромных анемий у беременных с нарушением углеводного обмена при использовании существующего лабораторного алгоритма обследования. Приводятся данные о неоднородности структуры анемического синдрома у женщин с сахарным диабетом 1-го типа. Особое внимание уделяется описанию роли гепсидина в метаболизме железа и механизмов регуляции его продукции в норме и при патологии. Приводятся ссылки на результаты исследований, подтверждающих целесообразность включения гепсидина в алгоритмы дифференциальной диагностики различных видов анемического синдрома. Затрагивается вопрос терапии анемии хронических заболеваний