Low Postprandial Circulating Inactive Ghrelin: Role of Early Satiety in Undernourished Children

Objective

To determine difference in the levels of circulating inactive ghrelin between undernourished and healthy children.

Methods

The present cross-sectional study was conducted in undernourished children from southwestern Iran, from July 2011 through July 2012. Postprandial inactive ghrelin levels were measured in 40 undernourished children and sex- and age-matched healthy controls by enzyme immunoassay.

Results

The levels of postprandial inactive ghrelin were considerably lower in undernourished compared to the healthy children (6.4 vs. 12.9, P?vs. 7.1, P?=?0.032).

Conclusions

Thus, the levels of inactive ghrelin was found to be low in undernourished children compared to healthy children. Early loss of appetite might be a result of low circulating inactive ghrelin levels in the postprandial state in undernourished children.     

Lemierre’s syndrome with double heterozygote status in the methylenetetrahydrofolate reductase gene

Background

There are some risk factors being more vulnerable to Lemierre’s syndrome such as a hypercoagulable state.

Methods

We report a rare case of Lemierre’s syndrome with ethmoid and maxillary sinusitis, bilateral mastoiditis, and sigmoid sinus thrombosis.

Results

Genetic study revealed a double heterozygote status in the methylenetetrahydrofolate reductase gene including C677T and A1298C.

Conclusion

It is suggested to screen patients with Lemierre’s syndrome for a hypercoagulable state to consider anticoagulant therapy.     

Advanced age exacerbates the pulmonary inflammatory response after lipopolysaccharide exposure

OBJECTIVE: The aged population is at a higher risk of mortality as a result of complications of injury or infection, such as acute lung injury. The objective of this study was to analyze pulmonary inflammatory responses in young and aged mice after administration of lipopolysaccharide. DESIGN: Prospective, controlled laboratory study. SETTING: Animal resource facilities and research laboratory. SUBJECTS: Young (2-3 months old) and aged (18-20 months old) female BALB/c mice. INTERVENTIONS: Animals received intraperitoneal injection of lipopolysaccharide derived from Pseudomonas aeruginosa. Control mice received saline alone. After 24 hrs, mice were killed. Pulmonary neutrophil infiltration was assessed histologically and by myeloperoxidase activity. Pulmonary levels of the CXC chemokines, monocyte inflammatory protein-2 and KC, and cytokines, tumor necrosis factor-alpha and interleukin-1beta, were assessed by enzyme-linked immunosorbent assay. MEASUREMENTS AND MAIN RESULTS: Lungs of aged mice given lipopolysaccharide showed a six-fold higher neutrophil infiltration and three-fold higher level of myeloperoxidase activity than lungs of young mice given lipopolysaccharide. Pulmonary levels of monocyte inflammatory protein-2 and KC were significantly higher in the lungs of aged mice given lipopolysaccharide, compared with younger mice. Levels of tumor necrosis factor-alpha and interleukin-1beta in the lung were analyzed as well. After lipopolysaccharide treatment, there was no difference in the level of tumor necrosis factor-alpha in lungs of young and aged animals, but interleukin-1beta was two-fold higher in the lungs of the aged group. These data suggest that at this time point, interleukin-1beta may contribute to the higher production of CXC chemokines observed in lungs of aged mice vs. young mice receiving lipopolysaccharide. CONCLUSIONS: The hyperreactive systemic inflammatory response seen in aged individuals after lipopolysaccharide administration is accompanied by an exacerbated pulmonary inflammatory response, which may contribute to the higher mortality seen in the aged given an inflammatory insult.     

The Risk of Sleep Disorder Among Persons with Mild Traumatic Brain Injury

Sleep disorders and mild traumatic brain injury (mTBI) are among the most commonly occurring neurological problems clinicians encounter simultaneously. Each can cause the other, and both share common predisposing factors. An important question that remains to be addressed is whether high-risk groups can be defined. We observed an accumulation of considerable knowledge on sleep dysfunction in mTBI in recently published works. The results highlight sleep disturbances in mTBI as the product of diverse internal and external influences, acting on a genetically determined substrate. This may partially explain the clinical heterogeneity of mTBI, pointing to the importance of establishing an accurate history on the onset and course of a specific sleep disorder in the early stages post-mTBI in the individual patient. Such an approach will aid not only diagnosis and treatment but may also lead to identification of disorders whose symptoms mimic those of TBI and thereby direct the most suitable treatment and management.     

Intermittent pneumatic compression therapy improves functional and dynamic balance and neuropathy severity in neuropathic patients with type 2 diabetes

Diabetic neuropathy is a common complication of diabetes which increases risk of falling. Reduction in neural blood flow is one proposed theory for this etiology of diabetic neuropathy. Intermittent pneumatic compression (IPC) is a treatment method that increases nutritional supplies for the peripheral nervous system. The current study aims at evaluating the effects of IPC therapy on two aspects of balance dysfunction as one of the most important clinical signs of diabetic neuropathy. This study is a single-blind, randomized, controlled clinical trial that involved 39 patients with diabetic peripheral neuropathy. In this analysis, patients aged 40–75 years (with a mean age of 58.82 years) were randomly divided into intervention (n = 20) and control groups (n = 19). In the first session, all tests of neuropathy severity (using Valk and Michigan diabetic neuropathy questionnaires) and stability (functional and dynamic balance) were performed for both groups. The subjects in intervention group underwent 10 sessions of IPC treatment. At last, balance and neuropathy examinations were carried out in the final session. P < 0.05 was chosen as statistical significance level. Implementation of IPC interventions for 10 sessions significantly decreased APSI and OSI of Biodex balance system in level 6 (P < 0.05). The subjects in intervention group showed significant increases in standing time with their eyes either open or closed by performing functional balance tests. Additionally, Valk and Michigan neuropathy screening scores significantly decreased after 10 sessions of IPC therapy. This study showed that IPC has a positive effect on diabetic neuropathy and balance.