Resistance to insulin mediated glucose disposal in obese subjects: respective effect of lipid metabolism and glycemia.

The present study was designed to assess the respective effect of altered lipid metabolism and hyperglycemia on glucose metabolism in vivo in obese subjects. Six young obese non-diabetic volunteers were studied on four occasions during hyperinsulinemic clamp, twice during euglycemia and twice during hyperglycemia, with or without the infusion of beta-pyridylcarbinol, an inhibitor of lipid metabolism. Glucose oxidation was calculated from continuous respiratory exchange measurements, and glucose storage was obtained as the difference between total glucose disposal and glucose oxidation. Two-way analysis of variance (with interaction term) demonstrated (i) a significant increase for total glucose disposal with beta-pyridylcarbinol but no significant effect of hyperglycemia and no interaction between the two treatments, and (ii) an important increase of beta-pyridylcarbinol to enhance glucose storage but no significant effect of hyperglycemia and no interaction between the two treatments. These results show that obese people, at physiological insulinemia, enhance their glucose disposal and glucose storage when lipid oxidation is artificially lowered. This suggests that enhanced lipid oxidation is related to insulin resistance in these patients. However, hyperglycemia in these patients failed to compensate for defective glucose disposal or storage.     

Parental assessment of childhood social phobia: psychometric properties of the social phobia and anxiety inventory for children-parent report.

Validity and parent-child agreement of the Social Phobia and Anxiety Inventory for Children-Parent Report (SPAI-C-P) were examined in a racially diverse sample of 158 students in Grades 5 through 8 (87 girls; ages 10 to 14; M = 11.53) and their caregivers. Children completed the Social Phobia and Anxiety Inventory for Children (SPAI-C), and caregivers completed the SPAI-C-P and the Child Behavior Checklist (CBCL). The SPAI-C-P demonstrated good internal consistency and was significantly correlated with child self-reported social anxiety. Confirmatory factor analysis supported a 3-factor model over a 5-factor model, and concurrent validity was evidenced. Implications and directions for future research are discussed.     

Extra- and intracellular free iron and the carotid body responses

The hypothesis that chelation of free iron, by decreasing reactive oxygen species (ROS), might mimic hypoxia and stimulate the carotid body was tested. We used the iron chelators, desferrioxamine (DFO, 200-400 microM) initially, and later ciclopirox olamine (CPX, 2.5-5.0 microM), on rat carotid body in vitro and measured chemosensory activity and [Ca2+]i in isolated cultured glomus cell clusters during normoxia and hypoxia. Although acute treatment of DFO might not penetrate the cell, and extracellular DFO would not influence these activities whereas CPX significantly increased chemosensory activities as well as increased [Ca2+]i in normoxia. We concluded that chelation of extracellular free iron did not alter ROS formation and oxygen sensing. Chelation of intracellular free iron and, therefore, a decrease in intracellular ROS appears to influence oxygen sensing in the carotid body.     

Human immune response to outer membrane protein CD of Moraxella catarrhalis in adults with chronic obstructive pulmonary disease

Moraxella catarrhalis is a common cause of lower respiratory tract infection in adults with chronic obstructive pulmonary disease (COPD). The antibody response to outer membrane protein (OMP) CD, a highly conserved surface protein of M. catarrhalis under consideration as a vaccine antigen, was studied in adults with COPD following 40 episodes of infection or colonization. Following infection or colonization, 9 of 40 patients developed new serum immunoglobulin G (IgG) to OMP CD, as measured by enzyme-linked immunosorbent assay. Adsorption assays revealed that a proportion of the serum IgG was directed toward surface-exposed epitopes on OMP CD in six of the nine patients who developed new IgG to OMP CD. Immunoblot assays with fusion peptide constructs indicated that the new antibodies that developed after infection or colonization recognized conformational epitopes, particularly in the carboxy region of the protein. Three of 28 patients developed new mucosal IgA to OMP CD in sputum supernatants. This study establishes that OMP CD is a target of a systemic and mucosal immune response following infection and colonization in some patients with COPD.     

Immune reconstitution inflammatory syndrome in association with HIV/AIDS and tuberculosis: Views over hidden possibilities

Background  

CD4+ T lymphocyte (CD4) cell count testing is the standard method for determining eligibility for antiretroviral therapy (ART), but is not widely available in sub-Saharan Africa. Total lymphocyte counts (TLCs) have not proven sufficiently accurate in identifying subjects with low CD4 counts. We developed clinical algorithms using TLCs, hemoglobin (Hb), and body mass index (BMI) to identify patients who require ART.     

Zur Anwendung des Rektaltemperatur-Todeszeit-Nomogramms am leichenfundort

Summary The application of the rectal temperature time of death nomogram at the scene of death by 11 authors from 6 lego-medical institutes resulted in a standard deviation of the differences between nomographic and real death time of ± 1.3 h in 46 cases (group I) with met requirements and clearly defined points of contact, nevertheless, including 9 cases with a more progressive cooling (0.5 > Q 0.2). In cases with a real death time of more than 4 h (N = 26) the standard deviation was ± 1.0 hours corresponding to permissible variation of 95% of ± 2.0 hours. Consequently, the permissible variation of 95% was much smaller than that suggested by the nomogram. The nomographic death time interval did not agree with the real one in 5 cases out of additional 30 cases with recognizably unsure points of contact (group II).     

Insulin, macronutrient intake, and physical activity: are potential indicators of insulin resistance associated with mortality from breast cancer?

High levels of insulin have been associated with increased risk of breast cancer, and poorer survival after diagnosis. Data and sera were collected from 603 breast cancer patients, including information on diet and physical activity, medical history, family history, demographic, and reproductive risk factors. These data were analyzed to test the hypothesis that excess insulin and related factors are directly related to mortality after a diagnosis of breast cancer. The cohort was recruited from breast cancer patients treated at the British Columbia Cancer Agency between July 1991 and December 1992. Questionnaire and medical record data were collected at enrollment and outcomes were ascertained by linkage to the BC Cancer Registry after 10 years of follow-up. The primary outcome of interest was breast cancer-specific mortality (n = 112). Lifestyle data were analyzed using Cox proportional hazards regression models to relate risk factors to outcomes, controlling for potential confounders, such as age and stage at diagnosis. Data for biological variables were analyzed as a nested case-control study due to limited serum volumes, with at least one survivor from the same cohort as a control for each breast cancer death, matched on stage and length of follow-up. High levels of insulin were associated with poorer survival for postmenopausal women [odds ratio, 1.9; 95% confidence interval (CI), 0.7-6.6, comparing highest to lowest tertile, P trend = 0.10], while high dietary fat intake was associated with poorer survival for premenopausal women (relative risk, 4.8; 95% CI, 1.3-18.1, comparing highest to lowest quartile). Higher dietary protein intake was associated with better survival for all women (relative risk, 0.4; 95% CI, 0.2-0.8, comparing highest to lowest quartile).