Protective Effect of Oral Acetylcysteine against the Hepatorenal Toxicity of Carbon Tetrachloride Potentiated by Ethyl Alcohol

Considering the well-documented protection of acetylcysteine (AC) in hepatotoxicity related to acetaminophen, we studied the preventive potential of AC against mild hepatotoxicity of CCl4, potentiated with ethyl alcohol (ETH) and the role of tissue glutathione. Rats fed a liquid diet with 30% of energy from ETH, had-intraperitoneal CCl4 administered in three injections, at 7-day intervals. AC was ingested at the level for acetaminophen overdose. ETH markedly potentiated the injury induced by CCl4, as evidenced by higher values of serum alanine aminotransferase (ALT), urinary bile acids (BA), serum creatinine, histological score of liver cell necrosis, mortality and by lower body weights and lower liver glutathione, when compared with CCl4 alone. Protective effect of AC consisted of a lesser hepatocytic necrosis, better body weights and higher liver glutathione. We conclude, that AC favorably modifies liver damage induced by CCl4 and potentiated with ETH. There is a preventive role for AC in subjects who combine ETH overuse with exposure to hepatotoxic xenobiotics, whose toxicity is modified by tissue glutathione.     

Physical inactivity in patients with rheumatoid arthritis: data from twenty-one countries in a cross-sectional, international study

OBJECTIVE: Regular physical activity is associated with decreased morbidity and mortality. Traditionally, patients with rheumatoid arthritis (RA) have been advised to limit physical exercise. We studied the prevalence of physical activity and associations with demographic and disease-related variables in patients with RA from 21 countries. METHODS: The Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis (QUEST-RA) is a cross-sectional study that includes a self-report questionnaire and clinical assessment of nonselected consecutive outpatients with RA who are receiving usual clinical care. Frequency of physical exercise (>or=30 minutes with at least some shortness of breath, sweating) is queried with 4 response options: >or=3 times weekly, 1-2 times weekly, 1-2 times monthly, and no exercise. RESULTS: Between January 2005 and April 2007, a total of 5,235 patients from 58 sites in 21 countries were enrolled in QUEST-RA: 79% were women, >90% were white, mean age was 57 years, and mean disease duration was 11.6 years. Only 13.8% of all patients reported physical exercise>or=3 times weekly. The majority of the patients were physically inactive with no regular weekly exercise: >80% in 7 countries, 60-80% in 12 countries, and 45% and 29% in 2 countries, respectively. Physical inactivity was associated with female sex, older age, lower education, obesity, comorbidity, low functional capacity, and higher levels of disease activity, pain, and fatigue. CONCLUSION: In many countries, a low proportion of patients with RA exercise. These data may alert rheumatologists to motivate their patients to increase physical activity levels.     

Effects of canagliflozin on initiation of insulin and other antihyperglycaemic agents in the CANVAS Program

This study compared initiation of insulin and other antihyperglycaemic agents (AHAs) with canagliflozin versus placebo for participants with type 2 diabetes and a history/high risk of cardiovascular disease in the CANagliflozin cardioVascular Assessment Study (CANVAS) Program. After 1 year, fewer participants treated with canagliflozin versus placebo initiated any AHA (7% vs. 16%), insulin (3% vs. 9%) or any non-insulin AHA (5% vs. 12%) (P < .001 for all); overall AHA initiation rates increased over time but were consistently lower with canagliflozin compared with placebo. During the study, the likelihood of initiating insulin was 2.7 times lower for participants treated with canagliflozin compared with placebo (hazard ratio, 0.37; 95% CI: 0.31, 0.43; P < .001). The time difference between 10% of patients in the canagliflozin and placebo groups being initiated on insulin from the beginning of the trial was about 2 years. Time to initiation of other AHAs, including metformin, dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists and sulphonylureas, was also delayed for canagliflozin versus placebo (P < .001 for each). Compared with placebo, canagliflozin delayed the need for initiation of other AHAs and delayed time to insulin therapy, an outcome that is important to many people with diabetes.     

Tie – an Accessory Fashion Detail or a Symbol?

Aim

The first aim of this study was to establish the frequency of wearing a tie or business neckerchief on different occasions and in relation to age and educational level. The second aim was to establish whether men who frequently wear a tie were attributed certain characteristics more often than men who rarely wear a tie and to establish whether there were differences in the attribution of these characteristics according to sex, age, educational level, and the frequency of wearing a tie.

Method

Data were collected in 2005 by a method of face to face interview on a national representative sample (n = 1007). Participants estimated how often they wore a tie or business neckerchief on 9 different occasions. They also estimated whether each of 14 characteristics was more pronounced in men who frequently wear a tie.

Results

Tie was most frequently worn on festive and formal occasions, such as weddings and festive gatherings, and least frequently on family gatherings and when traveling. On all occasions, tie was more often worn by men of higher educational level and of older and middle age. A relatively small proportion of Croatian citizens based their conclusions on men’s characteristics on the frequency of wearing a tie. Men who frequently wear a tie were relatively most often attributed the characteristics of ambition, politeness, and respectability, with significant differences found between persons who attributed these characteristics according to sex, age, educational level, and the frequency of wearing a tie by the participants themselves.

Conclusion

Wearing a tie or neckerchief is an exception rather than a rule for most of the Croatian population, and is associated only with specific, primarily festive and formal occasions. Such use of the tie suggests that people adapt their style of clothing to the expectations of others and use it as a specific symbol of the occasion.Clothing is a form of non-verbal communication and represents a systematic way of conscious or unconscious information transmission (1). What distinguishes clothing from other forms of non-verbal communication is that it is the first thing we notice when we meet a person for the first time. Clothing can influence our first impression of a person, create stereotypes, and influence our behavior toward that person (2,3). Therefore, we use clothing as a channel of non-verbal communication for self-presentation and impression management (4). Clothing is also important for our self-concept, since it allows us to feel safer, more assertive, more powerful, and more comfortable in a given situation (4,5). Besides that, the clothes we wear are an example of normative social influence (6), ie the influence we conform to in order to be accepted by a desired social group.More systematic investigation on the influence of clothes on interpersonal relations began in the 1970s and by now a large number of studies have confirmed that people form the impressions on other people on the basis of their physical appearance, especially clothes (7). For example, Damhorst (8), in his review, concluded that 94% of the analyzed experimental studies showed an influence of clothes on the impression formation. Research showed that the way a person is dressed influences the conclusions other people make on their traits and characteristics, such as reliability, competence, power/status, or their workplace (9-13). People not only base their conclusions on clothes itself but also on the appropriateness of clothes to the occasion (7). Different roles or social positions and different occupations or work places are often related to different social norms, including the clothing norm (4,14-16). Even when we do not place much importance on social roles, we still use clothing to adapt to the situation because we care about the reactions of others. Also, appropriate clothing facilitates social interaction and helps us feel more comfortable (4,5). People use clothes to demonstrate similarities in values and beliefs with members of their own group, as well as differences from the groups they do not belong to (17-19). The choice of clothes can show our disagreement with certain norms or terminate unwanted social interactions.The greatest part of the research on the influence of clothes on impression formation and management was conducted in business situations and is related to conventional or classic clothing style (14-16,20). These studies have shown that the applicant’s clothing at interview has an influence on whether he or she will get a job, and that classically or conventionally dressed people are more positively evaluated. Classic or conventional clothing includes a suit for both men and women and a tie for men. It has been proven that this style of clothing is associated with competence and authority in both men and women, not only in business situations (15,21-25).According to the available data, 600-700 million people across the world wear a tie every day, and more than two billion Euro is spent on ties every year, which is more than a yearly budget of some smaller states (26). According to Johnson (27), the earliest known version of the tie was found in the mausoleum of the first emperor of China, Shih Huang Ti, who was buried in 210 BC. Tie’s modern history began in the 17th century, when Croatian soldiers fighting in the Thirty Years'' War spread its forerunner, known as the cravat, all over Europe. In his monograph Le grande histoire de la cravate, Francois Chaille confirms and discusses the Croatian origin of the cravat (Figure 1), while the Encyclopćdia Britannica states that the noun “cravat” originated from the words Crabata, Cravata, and Croatian, mentioning the year 1656 as the year of its appearance (26). The French readily accepted the special way of tying a piece of cloth around the neck “a la Croate” and citizens of Paris soon took it to be a symbol of progress (26). During the French revolution, black cravats were worn as a sign of protest against reactionary ideas, and the cravat soon became a symbol of culture and elegance (26). While the French saw the cravat as a decoration and a symbol of progress, for the Croatian it was primarily a symbol of fidelity. According to the popular tradition, wives and girlfriends would give cravats to soldiers as a token of their love, to give them courage and comfort in difficulties and danger. On the other hand, by wearing a cravat, the soldier would show the respect for his beloved. This custom symbolized a man''s loyalty to a woman, as well as established loyalty as a virtue (28). Therefore, through the history, the tie has symbolized loyalty, culture, refinement, style, and elegance; according to Johnson (27) the tie has symbolized social status, occupation/work place, identity, as well as group belonging.Open in a separate windowFigure 1Tie with a traditional Croatian pattern called pleter.In order to examine contemporary symbolical connotations of the tie, we analyzed the frequency of wearing a tie on various occasions among the citizens of Croatia of different age and educational level, as well as the characteristics attributed to men who frequently wear a tie. Since tie is a garment worn usually by men, we analyzed the frequency of wearing a business neckerchief among women.Specific aims of the study were: 1) to establish the frequency of wearing a tie orbusiness neckerchief on different occasions among people of different age and educational levels; 2) to establish whether men who frequently wear a tie were attributed certain characteristics more often than men who wear a tie rarely and to establish whether there were differences in the attribution of these characteristics according to age and educational levels; and 3) to establish whether there are differences between men in the attribution of characteristics to other men who frequently wear a tie with regard to the number of different situations in which men themselves frequently wear a tie.     

Sodium-glucose co-transporter-2 inhibition and ocular outcomes in patients with type 2 diabetes: A systematic review and meta-analysis

Sodium-glucose co-transporter-2 (SGLT2) inhibitors are effective for the treatment of macrovascular complications and nephropathy in type 2 diabetes, but effects on microvascular eye outcomes are unclear. We conducted a systematic review and meta-analysis of randomized placebo-controlled trials to evaluate the effect of SGLT2 inhibition on total ocular events and retinopathy in patients with type 2 diabetes. We searched MEDLINE and Embase for the period from database inception date to October 11, 2019. Two reviewers working independently extracted relevant data. Random-effects models with inverse variance weighting were selected to estimate summary risk ratios (RRs) and 95% confidence intervals (CIs). We included nine studies, involving 39 982 patients with a mean follow-up of 2.8 years. There were 1414 total ocular events, of which 624 were retinopathy events. SGLT2 inhibition was not associated with a change in the risk of total ocular events (RR 0.97, 95% CI 0.85, 1.11) or retinopathy (RR 0.98, 95% CI 0.84, 1.16), with consistent effects across studies (P for heterogeneity = 0.35 and 0.45, respectively). The effects of SGLT2 inhibition on eye disease in individuals with type 2 diabetes are probably null, although the available data cannot exclude small to moderate benefits or harms.     

The effects of canagliflozin on heart failure and cardiovascular death by baseline participant characteristics: Analysis of the CREDENCE trial

Heart failure is prevalent in those with type 2 diabetes and chronic kidney disease, and is associated with significant mortality and morbidity. In the CREDENCE trial, canagliflozin reduced the risk of hospitalization for heart failure (HHF) or cardiovascular (CV) death by 31%. In the current analysis we sought to determine whether the effect of canagliflozin on HHF/CV death differed in subgroups defined by key baseline participant characteristics. Cox regression models were used to estimate hazard ratios and 95% confidence intervals. Canagliflozin was associated with a reduction in the relative risk of HHF/CV death regardless of age, sex, history of heart failure or CV disease, and the use of loop diuretics or glucagon-like peptide-1 receptor agonists (all p_interaction > .114). The absolute benefit of canagliflozin was greater in those at highest baseline risk, such as those with CV disease (50 fewer events/1000 patients treated over 2.5 years vs. 20 fewer events in those without CV disease) or advanced kidney disease (estimated glomerular filtration rate [eGFR] 30–45 mL/min/1.73m²: 61 events prevented/1000 patients treated over 2.5 years vs. 23 events in eGFR 60–90 mL/min/1.73m²). Canagliflozin consistently reduces the proportional risk of HHF/CV death across a broad range of subgroups with greater absolute benefits in those at highest baseline risk.