The hypothalamic-pituitary-adrenal axis in the neuroendocrine regulation of food intake and obesity: The role of corticotropin releasing hormone

The aim of this paper is to review the present knowledge on the role of the hypothalamic-pituitary-adrenal axis in the control of food intake and the pathogenesis of obesity and to discuss, on the basis of available literature, the interactions between other neurosystems and this hormonal axis. Food intake is influenced by a system of physiologic signals and behavioral controls consisting of positive and negative sensory feedback mechanisms. It is regulated by a complex neuroendocrine system consisting of peripheral signals (cortisol, leptin) in constant interplay with central neurosystems such as the cocaine-amfetamine-regulated transcript system. In these neurosystems, corticotropin-releasing hormone, pro-opiomelanocortin, melanin-concentrating hormone and neuropeptide Y are actively involved. The corticotropin-releasing hormone system is widely distributed throughout the brain, but it is particularly abundant in the medial parvocellular division of the paraventricular nucleus. Within the brain corticotropin-releasing hormone with its two receptor types, its binding protein and its closely related peptide urocortin forms a network of neuronal pathways capable of interacting with other circuitries controlling food intake and sympathetically-mediated thermogenesis. A defect in the synthesis and release of corticotropin-releasing hormone has been implicated in the development of obesity in laboratory animals. This condition is alleviated by exogenous corticotropin-releasing hormone treatment. The relationship between the neuropeptide Y system and the hypothalamic-pituitary-adrenal axis is complex and seems to include positive feedback between neuropeptide Y and corticosteroids and negative feedback between corticotropin-releasing hormone and neuropeptide Y. Leptin is involved in the regulation of energy balance by interacting with the hypothalamic-pituitary-adrenal axis. In the past, we have shown by cross-correlation analysis, that under physiological conditions cortisol and plasma leptin levels are related to each other in a time-related negative and positive fashion over 24 h. © 2004 Taylor & Francis Ltd

The role of Internal Audit in Bank's performance

Στόχος αυτής της έρευνας είναι να προσδιορίσει το ρόλο που διαδραματίζει ο εσωτερικός έλεγχος στην απόδοση των χρηματοπιστωτικών ιδρυμάτων. Προκειμένου να επιτευχθεί αυτό , εξετάζεται η σημαντικότητα του εσωτερικού ελέγχου σε ολόκληρο τον οργανισμό και η προστιθέμενη αξία που παρέχει. Η παρούσα εργασία αποτελείται από 2 ενότητες. Το θεωρητικό μέρος στο οποίο αναλύεται σχετική βιβλιογραφία και γίνεται αναφορά και στις προσδοκίες των ρυθμιστικών αρχών στον τραπεζικό τομέα. Στο δεύτερο μέρος υπάρχει η εμπειρική ανάλυση και τα συμπεράσματα αυτής. Η συλλογή των δεδομένων πραγματοποιήθηκε μέσω ερωτηματολογίου που απευθύνθηκε σε Εσωτερικούς Ελεγκτές και μέλη των Τμημάτων Διαχείρισης Κινδύνων των τεσσάρων συστημικών τραπεζών στην Ελλάδα. Τα αποτελέσματα της έρευνας έδειξαν ότι η αντίληψη απέναντι στον εσωτερικό έλεγχο στον τραπεζικό τομέα έχει αλλάξει σημαντικά σε σύγκριση με το παρελθόν. Ο εσωτερικός έλεγχος θεωρείται ως ένας πολύτιμος εταίρος όχι μόνο για τη διασφάλιση της συμμόρφωσης με τους νόμους, αλλά συμβάλει και στην υλοποίηση μιας επιτυχημένης στρατηγικής δημιουργώντας αξία σε όλες τις λειτουργίες μιας τράπεζας.The aim of this research is to identify the role Internal Audit plays in the performance of Credit Institutions. In order to fulfill this scope, the importance of Internal Audit throughout the organization and the added valued it provides, are examined. The current thesis is consisted of an analysis of the theoretical foundations of Internal Audit, the expectations of Regulatory Authorities in the Banking Sector, the Empirical Analysis and the Conclusions. The collection of the data was carried out through a questionnaire addressed to Internal auditors and members of the Risk Management Departments of the four systemic banks in Greece. The results of the survey indicated that the perception towards IA in banking sector has considerably changed compared with some years ago. Now IA is regarded as a valuable partner not only in assuring regulatory compliance but in strategy accomplishment too by creating cost efficiencies across all bank’s units

Common pathophysiological mechanisms involved in luteal phase deficiency and polycystic ovary syndrome. Impact on fertility

Luteal phase deficiency (LPD) is a consequence of the corpus luteum (CL) inability to produce and preserve adequate levels of progesterone. This is clinically manifested by short menstrual cycles and infertility. Abnormal follicular development, defects in neo-angiogenesis or inadequate steroidogenesis in the lutein cells of the CL have been implicated in CL dysfunction and LPD. LPD and polycystic ovary syndrome (PCOS) are independent disorders sharing common pathophysiological profiles. Factors such as hyperinsulinemia, AMH excess, and defects in angiogenesis of CL are at the origin of both LPD and PCOS. In PCOS ovulatory cycles, infertility could result from dysfunctional CL. The aim of this review was to investigate common mechanisms of infertility in CL dysfunction and PCOS. © 2012 Springer Science+Business Media, LLC

Dysfunction of the Hypothalamic-Pituitary-Adrenal axis in HIV infection and disease

Abnormalities of the Hypothalamic-Pituitary-Adrenal (HPA) axis have been documented in HIV patients in the early as well as late stages of the infection and range from subtle subclinical disturbances to frank adrenal insufficiency. Potential etiologies of these disorders include opportunistic infections, neoplasms, drugs administered to treat infections, cytokine abnormalities associated with the HIV disease process and acquired alterations in tissue sensitivity to glucocorticoids. In this article, we present a concise review of HPA abnormalities in HIV infection and disease with regard to their etiology with emphasis on syndromes of hypersensitivity/resistance to glucocorticoids associated with antiviral medications and/or the HIV infection itself

Oocyte maturation in assisted reproductive techniques

Human oocyte maturation is a long process during which nuclear maturation occurs resulting in germinal vesicle breakdown (transition from prophase I to metaphase II) and extrusion of the first polar body. During oocyte maturation, in parallel with nuclear maturation, a number of events take place in the oocyte cytoplasm that assist fertilization and early embryonic development. So far several attempts have been made to mature human oocytes in vitro. The main patient group to which in vitro maturation (IVM) has been applied is polycystic ovarian syndrome. In a concise review we present the techniques used for the IVM of oocytes and the role of hormones and growth factors in IVM and subsequent fertilization and early embryonic development. © 2006 New York Academy of Sciences

Thyroglobulin antibodies as a potential predictive marker of papillary thyroid carcinoma in patients with indeterminate cytology

Backround We investigated the efficacy of thyroglobulin antibodies (TgAb) in detecting malignancy in indeterminate thyroid nodules and evaluated the possible association between TgAb and autoimmunity in papillary thyroid carcinoma (PTC). Methods This retrospective, nonrandomized study included 1,646 patients who had undergone preoperative fine-needle aspiration biopsy to evaluate their thyroid nodules, and then standard total thyroidectomy. Of 194 patients (11.8%) with indeterminate nodules, 61 (31.4%) had PTC and 133 (68.6%) had benign nodules at the final histologic examination. Results Univariate analysis showed that multifocality (P =.002), bilaterality (P =.003), lymph-node metastasis (P =.030), and capsule penetration (P =.003) were significantly associated with positive TgAb in patients with indeterminate cytology and histopathologic diagnosis of PTC. The multivariate analysis showed that TgAb positivity (P <.001) and preoperative thyroid-stimulating hormone levels (P =.022) were independent predictive factor for PTC diagnosis in patients with indeterminate cytology. Conclusions Preoperative TgAb could be a marker for PTC in patients with indeterminate thyroid nodules, increasing diagnostic accuracy. TgAb positivity could also influence the clinical assessment and subsequent selection of total thyroidectomy. © 2016 Elsevier Inc

Ενεργειακή επιθεώρηση ξενοδοχειακής μονάδας

Διπλωματική εργασία για την απόκτηση προπτυχιακού διπλώματοςΠερίληψη: Τα ξενοδοχεία είναι κτήρια με ιδιαίτερα με ιδιαίτερα υψηλές ενεργειακές καταναλώσεις λόγω της συνεχούς λειτουργίας τους και του πλήθους των φορτίων τους. Η συγκεκριμένη διπλωματική εργασία έχει σκοπό την βελτίωση της ενεργειακής απόδοσης ενός ξενοδοχείου στην Κεφαλονιά. Αυτό επιτυγχάνεται με την μείωση των ενεργειακών λειτουργιών του σε συνδυασμό με την διατήρηση ή και βελτίωση της ποιότητας των παρεχόμενων ενεργειακών υπηρεσιών. Για τον σκοπό αυτό θα γίνει αναλυτική αποτύπωση των κτηριακών εγκαταστάσεων του ξενοδοχείου καθώς και υπολογισμός των ενεργειακών καταναλώσεων εστιάζοντας στις ενεργειακές υποδομές και στην λειτουργία του. Γίνεται προσομοίωση των κτιρίων με τη χρήση του προγράμματος Google sketch up και μέσω του λογισμικού Open studio. Στη συνέχεια, με τη χρήση του ενεργειακού προγράμματος Energy plus πραγματοποιείται η ενεργειακή ανάλυσή του και εξάγονται συμπεράσματα για την ενεργειακή του απόδοση. Τέλος, παρατίθενται προτάσεις για την ενεργειακή αναβάθμιση του κτιρίου, οι οποίες προσομοιώνονται μέσω των ίδιων προγραμμάτων και αξιολογείται η αποτελεσματικότητα των προτεινόμενων λύσεων. Μετά την ολοκλήρωση της η εργασία θα δοθεί στο ξενοδοχείο προκειμένου να χρησιμοποιηθεί για την βελτίωση των εγκαταστάσεων του

HbA1c presents low sensitivity as a post-pregnancy screening test for both diabetes and prediabetes in Greek women with history of gestational diabetes mellitus

Background and aim: Women with a history of gestational diabetes mellitus (GDM) are at increased risk for type 2 diabetes (T2D). It is thus recommended that an oral glucose tolerance test (OGTT) be performed after delivery. Recently, the use of glycated haemoglobin A1c (HbA1c) has been proposed as a simpler and faster method to diagnose glucose disorders. The aim of this study was to investigate whether HbA1c measurement can replace OGTT in the detection of prediabetes and T2D in women with a history of GDM. Patients and methods: We studied 1336 women (35.3 ± 5.8 years old) with a history of GDM 16.6 ± 28.2 months after delivery. All women were evaluated through an OGTT and a simultaneous HbA1c measurement. American Diabetes Association (ADA) criteria were used for the assessment of glucose disorders. Sensitivity and specificity of HbA1c were measured for the prediction of T2D and prediabetes, while Cohen’s coefficient of agreement (k) was calculated. ROC analysis was performed to evaluate the sensitivity and specificity of HbA1c. Results: Based on OGTT, 725 women (54.3%) were normal, 406 (30.4%) presented impaired fasting glucose (IFG), 48 (3.6%) impaired glucose tolerance (IGT), 74 (5.5%) combined IFG+IGT, and 83 presented with T2D (6.2%). By contrast, using HbA1c as a screening test, 1150 women (94.1%) were normal, while 49 (4.0%) had prediabetes and 23 (1.9%) T2D. Sensitivity of HbA1c for the diagnosis of prediabetes was 5.3% in comparison to OGTT, specificity was 99.2%, while for the diagnosis of T2D, the percentages were 29.6 and 100%, respectively. The consistency in classifying impaired glucose tolerance between HbA1c and OGTT was 59.7%. Cohen’s coefficient of agreement was k = 0.116, indicating slight agreement. Performing a ROC curve, the optimal value of distinctive ability of HbA1c was 4.6% in the case of prediabetes, while for diabetes, it was 5.5%. Conclusion: This study provided evidence that HbA1c can identify fewer women with prediabetes and T2D than OGTT, indicating that HbA1c cannot be recommended as an alternative post-pregnancy screening method. © 2018, Hellenic Endocrine Society