Adipose tissue IL-6 content correlates with resistance to insulin activation of glucose uptake both in vivo and in vitro

Obesity and type 2 diabetes are associated with insulin resistance, the mechanisms of which remain poorly understood. A significant correlation between circulating IL-6 level and insulin sensitivity has recently been found in humans. Because adipose tissue could be a significant source of IL-6, we analyzed the relationship between the levels of adipose tissue IL-6 and insulin action in vivo, during a hyperinsulinemic normoglycemic clamp, and in vitro by measuring glucose transport in adipocytes from 12 obese subjects with (n = 7) or without (n = 5) diabetes. We observed an inverse correlation between adipose tissue IL-6 content and maximal insulin-responsiveness measured in vivo (P < 0.02) and in vitro (P < 0.02). Conversely, there was no significant correlation between these two later parameters and adipose tissue leptin or tumor necrosis factor-alpha protein contents. Furthermore, we showed, for the first time, the presence of immunoreactive IL-6 receptors in the plasma membrane of human abdominal sc adipocytes. This suggests that locally secreted IL-6 could act on adipocytes by an autocrine/paracrine mechanism. In conclusion, increased IL-6 production by sc adipose cells might participate to the insulin-resistant state observed in human obesity.     

Fat Versus Carbohydrate-Based Energy-Restricted Diets for Weight Loss in Patients With Type 2 Diabetes

Purpose of Review

The prevalence of combined obesity and diabetes has increased dramatically in the last few decades. Although medical and surgical weight management are variably effective in addressing this epidemic, it is essential to parallel these strategies with a hypocaloric diet comprising the appropriate macronutrient composition to induce weight loss, enhance glycemic control, and improve cardiovascular risk factors. This review reports the current evidence of the role of carbohydrates and fat-based diets for weight management in patients with combined type 2 diabetes (T2D) and obesity.

Recent Findings

Low-carbohydrate diets were shown to decrease postprandial glucose levels whereas high-carbohydrate, low-fat diets are considered cardio-protective.

Summary

A diet with an optimal macronutrient composition remains uncertain for patients with combined T2D and obesity. Further research is still needed to define the best dietary composition that achieves the maximum benefits on weight management, glycemic control, and cardiovascular risk factors.

     

Scanning electron microscopy of the four larval instars of the lymphatic filariasis vector Culex quinquefasciatus (Say) (Diptera: Culicidae)

Since Culex pipiens quinquefasciatus is the main vector of lymphatic filariasis in tropics and subtropics, the identification and quantification of this mosquito is an important task. Scanning electron microscopy reveals that morphological changes during larval development as the number of comb scale varies greatly and their complexity increases from first to the fourth instar. Also, their structures are more complex with a varying number of subapical denticles. The amount of pecten shows modifications at different larval instars with regard to the number and complexity of their spines. The pecten teeth increase in their number and complexity during development. The number of lateral palatal brush filaments increases during larval development from the first to the fourth instar. The ventral brush of the abdominal segment X in the first and second instars is composed of two respectively three pairs of setae while the third and fourth instars have four pairs of sturdy setae.     

Neonatal distal femoral epiphyseal dislocation: an ultrasound diagnosis

Traumatic epiphyseal dislocation related to birth injury is uncommon. The authors report a case of slipped distal femoral epiphysis during a breech presentation in a twin pregnancy birthing process, diagnosed by ultrasonography. This type of separation could be difficult to detect in the newborn on plain radiographs because of the non-ossification of the epiphysis. Therefore, the use of sonography is helpful to make an early and accurate diagnosis in order to avoid malunion and deformities of the affected limb. Through this case report we will see the diagnostic value of high-resolution ultrasonography in diagnosing newborn injuries of the limbs, and particularly in the diagnosis of radiographically occult epiphyseal separation.     

Outcomes of Older Patients with Resectable Colorectal Liver Metastases Cancer (CRLM): Single Center Experience

Surgery is the only potential curative option of CRLM if resectable. The curative approach in patients over 70 years old is challenging mainly because of comorbidities and other geriatric syndromes. Herein, we report outcomes of older patients with resectable CRLM in our center. We retrospectively analyzed characteristics and outcomes of older patients with CRLM operated at “Centre Hospitalier de l’Université de Montréal” (CHUM) between 2010 and 2019. We identified 210 patients aged ≥70 years with a median age of 76 (range: 70–85). CRLM were synchronous in 56% of patients. Median disease-free survival (DFS) was 41.3 months. Median overall survival (OS) was 62.2 months and estimated 5-year survival rate was 51.5% similar to those of younger counterparts. Patients with metachronous CRLM had a trend to a higher OS compared to those with synchronous disease (67.2 vs. 58.7 months; p = 0.42). Factors associated with lower survival in the multivariate analysis were right-sided tumors and increased Charlson Comorbidity index (CCI). Survival outcomes of patients aged ≥70 years were comparable to those of younger patients and those reported in the literature. Age should not be a limiting factor in the curative management of older patients with resectable CRLM.     

Mechanical properties of arteries cryopreserved at −80 °C and −150 °C

A new protocol for cryopreservation of arteries frozen at −80 °C was compared to the reference protocol for cryopreservation at −150 °C and to freshly harvested arteries. The aim of the study is to evaluate both protocols as global procedures to freeze and thaw arteries commonly used in tissue banks. Changes in mechanical properties of rabbit common carotid arteries were studied. Vascular segments were tested in vitro under dynamics loading conditions. Pressure and diameter were recorded simultaneously by a high fidelity transducer and an echotracking device, respectively. The pressure–diameter relationship was fitted by the arctangent Langewouters’ model and the arterial thickness was derived from histological measurements. Histological sections showed that the fresh and −80 °C groups were less damaged by hemodynamic load and histological preparation than the −150 °C group (p < 0.05). No differences between fresh and cryopreserved arteries regarding the structural (diameter, intimal-media thickness) and mechanical parameters (distensibility, circumferential stress, elastic modulus) were found. The isobaric circumferential stress was reduced in frozen arteries. These results demonstrate that the cryopreservation at −80 °C preserves the histological structure and mechanical properties better than the cryopreservation at −150 °C, suggesting that the new cryopreservation protocol at −80 °C is a method of choice for treating vessel replacement in vascular surgery.