Current Issue : July - September Volume : 2019 Issue Number : 3 Articles : 6 Articles
Endothelial dysfunction, impaired angiogenesis and cellular senescence in type 2 diabetes\nconstitute dominant risk factors for chronic non-healing wounds and other cardiovascular disorders.\nStudying these phenomena in the context of diabetes and the TSP1-CD-47 signaling dictated the use\nof the in vitro wound endothelial cultured system and an in vivo PVA sponge model of angiogenesis.\nHerein we report that diabetes impaired the in vivo sponge angiogenic capacity by decreasing cell\nproliferation, fibrovascular invasion and capillary density. In contrast, a heightened state of oxidative\nstress and elevated expression of TSP1 and CD47 both at the mRNA and protein levels were evident\nin this diabetic sponge model of wound healing. An in vitro culturing system involving wound\nendothelial cells confirmed the increase in ROS generation and the up-regulation of TSP1-CD47\nsignaling as a function of diabetes. We also provided evidence that diabetic wound endothelial\ncells (W-ECs) exhibited a characteristic feature that is consistent with cellular senescence. Indeed,\nenhanced SA-Beta-gal activity, cell cycle arrest, increased cell cycle inhibitors (CKIs) p53, p21 and p16\nand decreased cell cycle promoters including Cyclin D1 and CDK4/6 were all demonstrated in these\ncells. The functional consequence of this cascade of events was illustrated by a marked reduction\nin diabetic endothelial cell proliferation, migration and tube formation. A genetic-based strategy\nin diabetic W-ECs using CD47 siRNA significantly ameliorated in these cells the excessiveness in\noxidative stress, attenuation in angiogenic potential and more importantly the inhibition in cell cycle\nprogression and its companion cellular senescence. To this end, the current data provide evidence\nlinking the overexpression of TSP1-CD47 signaling in diabetes to a number of parameters associated\nwith endothelial dysfunction including impaired angiogenesis, cellular senescence and a heightened\nstate of oxidative stress. Moreover, it may also point to TSP1-CD47 as a potential therapeutic target in\nthe treatment of the aforementioned pathologies....
Background: Differentiated thyroid carcinoma (DTC), which includes the papillary and\nfollicular variants, is a common neoplasm. DTC has a very high cure rate and is treated surgically,\nusually followed by ablation of the post-surgical remnant with radioiodine. Case Presentation: The\ncase of a 68-year-old male patient who underwent a minimally invasive complete thyroidectomy on\nJuly 4, 2007 for capsulated follicular carcinoma with margins of excision exempted from neoplastic\ninfiltration (AJCC 2002 pT2 PNX PMX) is presented. Discussion: As the patient showed the presence\nof a pulmonary metastasis after 11 years, the potential implications of DTC follow-up management\nare here summarized. Conclusions: Follow up must be continued throughout life....
Objective: It was to evaluate the effect of diabetes education on emotional\ndistress in type 2 diabetes patients treated with oral medications. Methods:\nThe experimental study took place in Albania and overall, 200 type 2 diabetes\npatients were enrolled (in both groups, intervention, and control) treated\nwith oral medications, having levels of Glycated hemoglobin HbA1c > 6.5%\nas well the absence of associated diseases such as dementia and psychiatric\ndisorders. Patients were randomly selected from the medical registry of family\nphysicians in the Tirana region. Patients were screened for the emotional\ndistress before and after the intervention with the self-administered questionnaire\nProblem Areas in Diabetes PAID 5. In addition, the levels of HbA1c\nin % were evaluated before and after intervention in both groups. Only intervention\ngroup underwent four diabetes education sessions offered by trained\nnursing staff while the control group continued the previous regime. The\nquestionnaire reliability analysis was estimated by the Cronbach alpha coefficient.\nTo compare the groups the t-test was used and the value of p < 0.05 was\nconsidered significant. Results: Mean age of patients in intervention and\ncontrol group was respectively..........................
Background: Immune checkpoint inhibitors including nivolumab, an anti-programmed cell death protein 1 antibody, are\nrecently developed cancer immunotherapy agents. Immune checkpoint inhibitors are known to cause autoimmune-related\nside effects including endocrine dysfunctions. However, there are few reports on late-onset isolated adrenocorticotropic\nhormone (ACTH) deficiency caused by nivolumab.\nCase presentation: The patient was a 72-year-old female. When she was 64 years old, she was diagnosed with malignant\nmelanoma of the left thigh accompanied by left inguinal lymph node metastases, and she received several courses of\nchemotherapy for malignant melanoma followed by the resection of these lesions. At 71 years of age, multiple metastases\nwere found and treatment with nivolumab 2 mg/kg every 3 weeks was initiated. Six months later, replacement with\nlevothyroxine was started because of hypothyroidism following mild transient thyrotoxicosis. Eleven months after the\nbeginning of nivolumab, the treatment was discontinued because of tumor expansion. Four months after the\ndiscontinuation of nivolumab, general malaise and appetite loss worsened, and 2 months later, hyponatremia\n(Na; 120-127 mEq/L) and hypoglycemia (fasting plasma glucose; 62 mg/dL) appeared. Her ACTH and cortisol\nlevels were extremely low (ACTH; 9.6 pg/mL, cortisol; undetectable). Challenge tests for anterior pituitary\nhormones showed that responses of ACTH and cortisol secretion to corticotropin-releasing hormone were\ndisappeared, although responses of other anterior pituitary hormones were preserved. Thus, she was diagnosed with\nisolated ACTH deficiency. Her symptoms were improved after treatment with hydrocortisone.\nConclusions: The present report showed a case of late-onset isolated ACTH deficiency accompanied by hyponatremia,\nwhich was diagnosed 6 months after the discontinuation of nivolumab. The effects of nivolumab last for a long time\nand the side effects of nivolumab can also appear several months after discontinuation of the drug. Repeated\nmonitoring of serum sodium levels may be a beneficial strategy to find the unexpected development of adrenal\ninsufficiency even after discontinuation of nivolumab....
Background: As an insulin-dependent disease, type 1 diabetes requires paying close attention to the glycemic\ncontrol. Studies have shown that mobile health (mHealth) can improve the management of chronic diseases.\nHowever, the effectiveness of mHealth in controlling the glycemic control remains uncertain. The objective of this\nstudy was to carry out a systematic review and meta-analysis using the available literature reporting findings on\nmHealth interventions, which may improve the management of type 1 diabetes.\nMethods: We performed a systematic literature review of all studies in the PubMed, Web of Science, and EMbase\ndatabases that used mHealth (including mobile phones) in diabetes care and reported glycated hemoglobin\n(HbA1c) values as a measure of glycemic control. The fixed effects model was used for this meta-analysis.\nResults: This study analyzed eight studies, which involved a total of 602 participants. In the meta-analysis, the fixed\neffects model showed a statistically significant decrease in the mean of HbA1c in the intervention group:- 0.25\n(95% confidence interval:- 0.41,- 0.09; P = 0.003, I^2 = 12%). Subgroup analyses indicated that the patientâ??s age, the\ntype of intervention, and the duration of the intervention influenced blood glucose control. Funnel plots showed\nno publication bias.\nConclusions: Mobile health interventions may be effective among patients with type 1 diabetes. A significant\nreduction in HbA1c levels was associated with adult age, the use of a mobile application, and the long-term duration\nof the intervention....
Background: Sirtuin 1 (SIRT1) and sirtuin 3 (SIRT3) proteins have an important role in counteracting oxidative stress.\nAlthough diabetes and hypothyroidism (HT) are both characterized by oxidative stress, the mechanisms are not\nfully understood. This study investigated the effects of type 1 diabetes (T1D), type 2 diabetes (T2D), and HT on the\nexpression levels of SIRT1, SIRT3, and manganese superoxide dismutase (SOD2).\nMethods: Gene expression of SIRT1, SIRT3, and SOD2 was measured using real-time PCR. The protein expression of\nSOD2 and lipid peroxidation (thiobarbituric acid reactive substances) was measured by the TBARS Assay kit and\nenzyme-linked immunosorbent assay (ELISA) respectively.\nResults: The results showed that the SIRT1 and SIRT3 levels were lower in peripheral blood samples from patients\nwith T1D, T2D, or HT than in healthy individuals. Interestingly, the mRNA and protein expression levels of SOD2\nwere higher in all three patient groups. Lipid peroxidation was higher in the patients with HT than in the healthy\nindividuals.\nConclusions: These results indicate alterations in the expression levels of sirtuins and superoxide dismutase in\ndiabetes and HT, which may be related, at least in part, to the oxidative stress. Identifying such alterations in those\npatients will pave the way towards the development of drugs to enhance SIRT1 and SIRT3 expression and their\nactivity to prevent the damaging effect of oxidative stress....
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