Metabolic Perspectives for Non-classical Congenital Adrenal Hyperplasia With Relation to the Classical Form of the Disease

Non-classical congenital adrenal hyperplasia (NC-CAH) represents mild form of CAH with the prevalence of 0. 6 to 9% in women with androgen excess. Clinical and hormonal findings in females with NC-CAH are overlapping with other hyperandrogenic entities such as polycystic ovary syndrome hence causing difficulties in diagnostic approach. Metabolic consequences in subjects with NC-CAH are relatively unknown. We are lacking longitudinal follow of these patients regarding natural course of the disease or the therapeutic effects of the different drug regiments. Patients with NC-CAH similarly to those with classical form are characterized with deteriorated cardiovascular risk factors that are probably translated into cardiometabolic diseases and events. An increased preponderance of obesity and insulin resistance in patients with NC-CAH begin at young age could result in increased rates of metabolic sequelae and cardiovascular disease later during adulthood in both sexes. On the other hand, growth disorder was not proven in patients with NC-CAH in comparison to CAH patients of both gender characterized with reduced final adult height. Similarly, decreased bone mineral density and osteoporosis are not constant findings in patients with NC-CAH and could depend on the sex, and type or dose of corticosteroids applied. It could be concluded that NC-CAH represent a particular form of CAH that is characterized with specificities in clinical presentation, diagnosis, therapeutic approach and metabolic outcomes.This study was funded by the Serbian Ministry of Education, Science and Technological Development (grant numbers 175032 and 41009)

Fractional flow reserve in patients with intermediate values of Duke Treadmill Score and borderline coronary lesions

Despite the wide usage of exercise ECG tests and Duke Treadmill Score (DTS) in clinical practice, no comparison between this scoring system and Fractional Flow Reserve (FFR) has yet been made, particularly in cases of angiographically verified borderline lesions. Thirty patients with single coronary lesions and angiographically assessed borderline stenosis (between 30-70%) and previously calculated intermediate values of DTS between -10 to +4 were examined using FFR. Adequate specificity and sensitivity (0.769 and 0.556, respectively) were in a more narrow range of -0.5 to -10. Sex and age did not have an influence on the DTS values. There was a correlation between the values of FFR and age (r=0.395, p=0.031) and between angiographic assessment of stenosis and quantitative coronary angiography (QCA) (r=0.648, p<0.0001). In the study population, a decision on revascularization could not be based solely on angiographic or QCA assessment of the artery or on the values of DTS

Interaction Ruling Animal Collective Behaviour Depends on Topological rather than Metric Distance: Evidence from a Field Study

Numerical models indicate that collective animal behaviour may emerge from simple local rules of interaction among the individuals. However, very little is known about the nature of such interaction, so that models and theories mostly rely on aprioristic assumptions. By reconstructing the three-dimensional position of individual birds in airborne flocks of few thousands members, we prove that the interaction does not depend on the metric distance, as most current models and theories assume, but rather on the topological distance. In fact, we discover that each bird interacts on average with a fixed number of neighbours (six-seven), rather than with all neighbours within a fixed metric distance. We argue that a topological interaction is indispensable to maintain flock's cohesion against the large density changes caused by external perturbations, typically predation. We support this hypothesis by numerical simulations, showing that a topological interaction grants significantly higher cohesion of the aggregation compared to a standard metric one.Comment: To be submitted to PNAS - 25 page

An Approach of Integrating Communication Services in Applications for Android-Based Digital TV Receivers

Digital TV receivers are becoming increasingly powerful devices allowing consumers to not only watch television broadcasts but also to access the Internet or communicate to other devices in the same local area network through either an Ethernet connection or by using a wireless connection. As the living room represents a meeting place for family and friends to gather and socialize in, the possibility of playing informal games using the television set as the interaction device is very attractive. This paper presents a developed application that integrates new communication capabilities of digital TV receivers running the Android OS. The application is a game showing its content overlaid on top of a television program whereas Android mobile devices are used as controllers. The performance of the application is tested by measuring the response times of the various communication services and by analyzing feedback from a selected group of users

Accelerator Testing of the General Antiparticle Spectrometer, a Novel Approach to Indirect Dark Matter Detection

We report on recent accelerator testing of a prototype general antiparticle spectrometer (GAPS). GAPS is a novel approach for indirect dark matter searches that exploits the antideuterons produced in neutralino-neutralino annihilations. GAPS captures these antideuterons into a target with the subsequent formation of exotic atoms. These exotic atoms decay with the emission of X-rays of precisely defined energy and a correlated pion signature from nuclear annihilation. This signature uniquely characterizes the antideuterons. Preliminary analysis of data from a prototype GAPS in an antiproton beam at the KEK accelerator in Japan has confirmed the multi-X-ray/pion star topology and indicated X-ray yields consistent with prior expectations. Moreover our success in utilizing solid rather than gas targets represents a significant simplification over our original approach and offers potential gains in sensitivity through reduced dead mass in the target area.Comment: 18 pages, 9 figures, submitted to JCA

Molecular Analysis of Ring Y Chromosome in a 10-Year-Old Boy with Mixed Gonadal Dysgenesis and Growth Hormone Deficiency

Ring Y chromosome is a very rare chromosomal aberration. The published mixed gonadal dysgenesis (MGD) patients with a ring Y chromosome are short in stature, but are not growth hormone (GH) deficient. We present the molecular cytogenetic and molecular characterization of ring Y chromosome mosaicism in a 10-year-old boy with MGD whose short stature could be explained by the high percentage of cells monosomic for the X-chromosome, but also by the presence of severe GH deficiency. The ring Y chromosome in our patient is a de novo structural aberration. The fathers karyotype was normal

Distinguishing Type 2 Diabetes from Type 1 Diabetes in African American and Hispanic American Pediatric Patients

To test the hypothesis that clinical observations made at patient presentation can distinguish type 2 diabetes (T2D) from type 1 diabetes (T1D) in pediatric patients aged 2 to 18.Medical records of 227 African American and 112 Hispanic American pediatric patients diagnosed as T1D or T2D were examined to compare parameters in the two diseases. Age at presentation, BMI z-score, and gender were the variables used in logistic regression analysis to create models for T2D prediction.The regression-based model created from African American data had a sensitivity of 92% and a specificity of 89%; testing of a replication cohort showed 91% sensitivity and 93% specificity. A model based on the Hispanic American data showed 92% sensitivity and 90% specificity. Similarities between African American and Hispanic American patients include: (1) age at onset for both T1D and T2D decreased from the 1980s to the 2000s; (2) risk of T2D increased markedly with obesity. Racial/ethnic-specific observations included: (1) in African American patients, the proportion of females was significantly higher than that of males for T2D compared to T1D (p<0.0001); (2) in Hispanic Americans, the level of glycated hemoglobin (HbA1c) was significantly higher in T1D than in T2D (p<0.002) at presentation; (3) the strongest contributor to T2D risk was female gender in African Americans, while the strongest contributor to T2D risk was BMI z-score in Hispanic Americans.Distinction of T2D from T1D at patient presentation was possible with good sensitivity and specificity using only three easily-assessed variables: age, gender, and BMI z-score. In African American pediatric diabetes patients, gender was the strongest predictor of T2D, while in Hispanic patients, BMI z-score was the strongest predictor. This suggests that race/ethnic specific models may be useful to optimize distinction of T1D from T2D at presentation

In search of quality evidence for lifestyle management and glycemic control in children and adolescents with type 2 diabetes: A systematic review

<p>Abstract</p> <p>Background</p> <p>Our purpose was to evaluate the impact of lifestyle behavior modification on glycemic control among children and youth with clinically defined Type 2 Diabetes (T2D).</p> <p>Methods</p> <p>We conducted a systematic review of studies (randomized trials, quasi-experimental studies) evaluating lifestyle (diet and/or physical activity) modification and glycemic control (HbA1c). Our data sources included bibliographic databases (EMBASE, CINAHL^®, Cochrane Library, Medline^®, PASCAL, PsycINFO^®, and Sociological Abstracts), manual reference search, and contact with study authors. Two reviewers independently selected studies that included any intervention targeting diet and/or physical activity alone or in combination as a means to reduce HbA1c in children and youth under the age of 18 with T2D.</p> <p>Results</p> <p>Our search strategy generated 4,572 citations. The majority of citations were not relevant to the study objective. One study met inclusion criteria. In this retrospective study, morbidly obese youth with T2D were treated with a very low carbohydrate diet. This single study received a quality index score of < 11, indicating poor study quality and thus limiting confidence in the study's conclusions.</p> <p>Conclusions</p> <p>There is no high quality evidence to suggest lifestyle modification improves either short- or long-term glycemic control in children and youth with T2D. Additional research is clearly warranted to define optimal lifestyle behaviour strategies for young people with T2D.</p