Air Pollution and Serum Glucose Levels: A Population-Based Study

Recent studies demonstrated an adverse effect of chronic exposure to air pollution (AP) on metabolic syndrome and its components. In a population-based study, we investigated the association between exposure to ambient AP and serum glucose (SG), among subjects with normal glucose, impaired fasting glucose (IFG), and diabetes mellitus (DM).We included 1,063,887 SG tests performed in 131,882 subjects (years 2001–2012). Exposure data included daily levels of SO₂, NO₂ and other pollutants of industrial, traffic, and nonanthropogenic sources. Demographical, clinical, and medications purchase data were assessed. Log-transformed SG levels were analyzed by linear mixed models adjusted for seasonal variables and personal characteristics.SG increases (%increase [95% CI]), among subjects with normal glucose, IFG, and DM, respectively, were associated with 6.36 ppb increase of NO₂ measured 24 to 72 hours before the test (0.40% [0.31%; 0.50%], 0.56% [0.40%; 0.71%], and 1.08% [0.86%; 1.29%]); and with 1.17 ppb increase of SO₂ measured 24 hours before the test (0.29% [0.22%; 0.36%], 0.20% [0.10%; 0.31%], and 0.33% [0.14%; 0.52%]). Among DM population, weakest association was observed among patients treated with Metformin (0.56% increase in SG [0.18%; 0.95%]).In conclusion, NO₂ and SO₂ exposure is associated with small but significantly increased levels of SG. Although DM patients were found to be more susceptible to the AP induced SG variations, Metformin treatment seem to have a protective effect. Given the chronic lifetime exposure to AP and the broad coverage of the population, even small associations such as those found in our study can be associated with detrimental health effects and may have profound public health implications.     

Nasogastric tube, temperature probe, and bougie stapling during bariatric surgery: a multicenter survey

BackgroundAn adverse event in laparoscopic bariatric surgery that has not received much scrutiny involves tube/probe stapling or suturing during gastrectomy or gastroenterostomy.MethodsA retrospective analysis was performed using a questionnaire sent to all bariatric surgeons (n = 43) in Israel.ResultsEight surgeons reported on 17 cases in which intraoperative nasogastric/orogastric tube (n = 8), temperature probe (n = 6), or bougie stapling (n = 3) was identified. Laparoscopic sleeve gastrectomy was performed in 14 patients and laparoscopic gastric bypass in 3 patients. The patient demographics, operative details, and postoperative results are reported.ConclusionTube/probe complications can occur during laparoscopic bariatric surgery but are seldom reported. However, they can be associated with significant morbidity. The treatment options are dependent on the situation. More importantly, prevention strategies must include constant communication with the anesthesiologist and removal or relocation of a tube before stapling or suturing.     

Impaired ocular blood flow regulation in patients with open-angle glaucoma and diabetes

Background: To elucidate the potential impact of diabetes mellitus on primary open‐angle glaucoma pathology through vascular deficiency. Design: Cross‐section analysis from a longitudinal, prospective study. Participants: Eighty‐four open‐angle glaucoma patients (20 diabetic open‐angle glaucoma patients and 64 non‐diabetic open‐angle glaucoma patients) Methods: Patients were analyzed for ocular structure, ocular perfusion pressure (OPP), retrobulbar blood flow and retinal capillary perfusion. Statistical analysis was performed by SPSS version 18.0. Comparisons between groups were made as well as multivariate linear regression analysis. Main Outcome Measure: Retrobulbar blood flow and the retinal microcirculation. Results: Central retinal artery peak systolic velocity was 13.5% lower in diabetic patients (P = 0.007). In diabetic open‐angle glaucoma patients, ocular perfusion pressure positively correlated with central retinal artery and temporal posterior ciliary artery peak systolic velocity (R = 0.476, P = 0.039 and R = 0.529, P = 0.02, respectively), and with central retinal artery and nasal posterior ciliary artery resistance index (R = 0.537, P = 0.018 and R = 0.566, P = 0.012 respectively). Average retinal nerve fibre layer positively correlated with central retinal artery peak systolic velocity and temporal posterior ciliary artery end diastolic velocity (R = 0.501, P = 0.029 and R = 0.553, P = 0.019, respectively), and negatively correlated with superior and inferior retinal avascular space in the diabetic group (R = ?0.498, P = 0.030 and R = ?0.700, P = 0.001, respectively); no correlations were found in the non‐diabetic group. Negative correlations between retrobulbar and retinal circulations were only found in the diabetic open‐angle glaucoma patients, whereas positive correlations between retinal flow and non‐flow were only found in non‐diabetic open‐angle glaucoma patients. Conclusion: Diabetes may interfere with normal vascular regulation and contribute to glaucoma progression.     

Role of multi-detector row computed tomography for localization of acute lower gastrointestinal bleeding

BACKGROUND/AIMS: Recent studies have shown good performance for the detection of sources of gastrointestinal bleeding using multi-detector row computed tomography (MDCT). However, there are limited reports about the role of MDCT for localization of acute lower gastrointestinal (GI) bleeding. The purpose of this study was to evaluate the role of MDCT for detection and localization of acute lower gastrointestinal bleeding. METHODS: A total of 49 patients underwent MDCT examination for the evaluation of acute lower GI bleeding were investigated prospectively. Sensitivity, specificity, positive and negative predictive values of MDCT for the detection of acute lower GI bleeding were assessed. Colonoscopy, angiography, RBC scan or postoperative results were adopted as the reference standard. RESULTS: Sensitivity, specificity, positive and negative predictive values of MDCT for the detection of acute lower GI bleeding were 72.7%, 80%, 93.9% and 25%, respectively. Eighteen patients experienced massive bleeding and 5 of them could not undergo the colonoscopic examination due to massive bleeding. MDCT detected the bleeding focuses in all of 5 patients. CONCLUSIONS: MDCT is useful for the localization of acute lower GI bleeding. The procedure is brief, less invasive, and relatively accurate diagnostic method. Moreover, positive finding will allow directed therapeutic procedure such as angiography.     

Illness perceptions among osteoporotic men and women: correlates and gender differences

BackgroundAlthough osteoporosis is a major public concern, little research attention has been paid to evaluating the manner in which osteoporotic patients perceive their illness.The aim of the current study was to examine osteoporotic patients’ cognitive and emotional illness representations and to see, specifically, if any differences could be correlated with gender.MethodsA convenience sample of 102 women and 100 men (mean age 66 years in both groups) who were diagnosed with osteoporosis, and who were attending bone and mineral clinics at four major medical centers in Israel, participated in the study. Participants were interviewed face-to-face at the clinics or in their homes, using an adapted version of the Illness Perceptions Questionnaire (IPQ). Emotional illness representations were assessed using the state anxiety subscale from the State-Trait Personality Inventory (SPTI).ResultsParticipants perceived osteoporosis as a chronic but controllable disease. They perceived the disease as having few symptoms and mild consequences on their lives.ConclusionsOsteoporotic patients maintained a logical cognitive and emotional structure of their illness. Regarding gender differences, findings showed that women were more pessimistic than men regarding most of the illness representations’ dimensions. Gender differences in illness representations suggest women and men may benefit from different intervention programs, tailored according to their unique perceptions.     

In vivo and in vitro studies on the antimuscarinic activity of some amino esters of benzilic acid

The cholinergic antimuscarinic properties of some aliphatic and heterocyclic aminoesters of benzilic acid were evaluated in the CNS as well as in peripheral organs. Antagonism to hypothermia and to forced motor activity disturbances, both centrally mediated and induced in mice by oxotremorine, was kinetically determined in vivo. The antiacetylcholine activity of these compounds on the isolated guinea pig ileum, and their affinity for muscarinic high-affinity binding-sites in mouse brain homogenate were determined and correlated in vitro. 3-Quinuclidinyl benzilate (QNB) was found to be the most potent drug in vivo as well as in vitro, while dimethylaminoethyl benzilate was the least active. Atropine was as potent as scopolamine in the competition experiments in vitro but ten times less active in the two in vivo tests. Rate constants for the onset (k_on) and offset (k_off) of the antimuscarinic activity determined on the isolateed ileum, were found to increase and decrease, respectively, with the increase in the affinity of the drugs for the muscarinic binding-sites. The relationship between the molecular structure and the properties of these compounds is discussed in terms of the factors contributing to the observed rate constants of antimuscarinic activity and of the reasons for the decrease in the apparent potency of atropine in vivo.     

Methylation of 21-23 kD membrane proteins by a membrane-associated protein carboxyl methyltransferase in neuroblastoma cells. Increased methylation in differentiated cells

Membranes of neuroblastoma N1E-115 cells contain a specific protein carboxyl methyltransferase that methylates a 70 kD protein and a group of 21-23 kD proteins which are tightly bound to the membranes. The enzyme catalyzes the transfer of [methyl-3H] groups from [methyl-3H]S-adenosyl-L-methionine (Km = 0.22 microM) to these proteins to form base-labile carboxymethylesters. These protein methylesters are relatively stable compared to other protein methylesters, as shown by the ability of the 21-23 kD methylated proteins to retain their [methyl-3H] groups at pH values of 7 to 8.5 for at least 12 hr at room temperature. The extent of methylation of the 21-23 kD proteins, but not that of the 70 kD protein, was increased in membranes of cells induced to differentiate by 2% dimethyl sulfoxide (from a basal level of 0.1-0.2 to 0.9-1.2 pmol [methyl-3H] groups incorporated per mg membrane protein). This increase appeared after a lag period of 3 days of growth in the presence of the dimethyl sulfoxide and developed in parallel with the appearance of neurite-like processes in the cells. Kinetic experiments suggest that the amounts of 21-23 kD proteins available for methylation in the membranes of the undifferentiated and of the differentiated cells are limited. This and the previously observed low turnover of methylated 21-23 kD proteins in the intact cells suggest that the differentiated cells express and methylate more 21-23 kD proteins than the undifferentiated cells. These methylated proteins may be involved in differentiation or other functions of the differentiated cell membranes.     

Phenytoin and transmitter release at the neuromuscular junction of the frog

The effects of phenytoin (diphenylhydantoin, DPH) on transmitter release were studied at the frog neuromuscular junction. It was found that in Ringer's solutions containing a normal concentration of Ca²⁺ ions, DPH (1−2 × 10⁻⁴ M) depresses neurally evoked transmitter release, whereas in Ca²⁺-deficient Ringer's solutions it produces an increase in evoked release. Spontaneous transmitter liberation is augmented by DPH under all the above conditions. An abrupt disappearance of the evoked response occasionally occured with stimulation at 0.5 Hz, but a normal response could be elicited by a second stimulus delivered shortly after the first. At 100–200 Hz, DPH regularly induced a partial block in synaptic transmission. In8mM MgCl₂, this phenomenon appeared at 50 Hz and developed into a total neuromuscular blockade.     

Oral health status and dental needs of an autistic population of children and young adults

Behavior of patients with autistic syndrome makes delivery of oral hygiene and dental treatment a problem. In this study, the oral health and needs of two groups of patients with autism were evaluated: noninstitutionalized children with a mean age of 11 and institutionalized adults with a mean age of 22. The latter group had severe periodontal problems; almost half required periodontal surgery. Many of the children also needed periodontal treatment. Adults were found to have lower decayed, missing, and filled teeth (DMFT) scores than functionally independent Israeli persons of the same age. This finding was surprising because institutionalized adults are predisposed to development of dental caries; they frequently consume sweets, have poor oral hygiene, and do not use fluoride. Noninstitutionalized children with autism had caries rates that were similar to rates of functionally independent peers.