p38-MAPK and CDK5,signaling pathways in neuroinflammation:a potential therapeutic intervention in Alzheimer's disease?

Alzheimer’s disease(AD),the most common type of dementia,affects millions of people worldwide,putting a significant strain on healthcare infrastructure and societal resources.AD is characte rized by the build-up of amyloid-beta(Aβ)plaques and neurofibrillary to ngles containing hyperphosphorylated tau protein.

Innovative endoscopic enucleations of the prostate--Xie’s Prostate Enucleations

In the past 2 decades,endoscopic enucleation of the prostate has become a safe and effective surgical treatment for benign prostatic hyperplasia(BPH),with comparable outcomes to traditional surgeries.Transurethral vapor enucleation and resection of the prostate(TVERP),transurethral vapor enucleation of the prostate(TVEP),and ultrasound-navigated TVEP(US-TVEP)are new,innovative endoscopic enucleation procedures.These procedures are named Xie’s Prostate Enucleations(Xie’s Procedures for short).Current clinical data indicate that Xie’s Procedures are safe and effective treatment options for patients with BPH,especially for patients with larger prostates.Further prospective,randomized clinical trials compared with traditional transurethral resection of prostate(TURP)are still needed.

Diabetes Mellitus and Diabetic Peripheral Neuropathy

Diabetes mellitus (DM) is considered a major public health problem because of its high prevalence and progressive increase of incidence. DM chronic complications are major causes of morbidity and mortality, among which diabetic neuropathy (DN) stands out, affecting 30% - 50% of DM patients. An appropriate medical approach, involving anamnesis and thorough clinical examination, is extremely important for the early diagnosis of DN and, therefore, to the prevention of its complications, including the amputation of limbs. Despite of the importance of DN prevention and treatment, in order to provide improved quality of life and longevity to DM patients, current therapeutic options are very limited with respect to both symptom control and as effective disease therapies. Intensive glucose control is extremely important in order to prevent and avoid the progression of DN, as demonstrated in two large multicenter studies involving patients with type 1 DM, the DCCT (Diabetes Control and Complications Trial) and the EDIC (Epidemiology of Diabetes Interventions and Complications).

Artificial Sweeteners as a Cause of Obesity: Weight Gain Mechanisms and Current Evidence

The obesity epidemic gathers growing media attention recently, as overweight and obesity’s prevalence keeps rising. This comes along with an increase in the intake of artificial sweeteners in food products. A causal relationship between the consumption of sweeteners and obesity is so far not clear in the medical literature. This paper describes the development of artificial sweeteners in a historical context. It collects epidemiological and experimental evidence that possibly relates the use of artificial sweeteners with weight gain. Finally, these effects are explained based on the neuroscience of food reward, the possible effects of glucose on the metabolism and the association between sweeteners and gut microbiota.

Anti-Inflammatory Effects of Physical Exercise on Obesity

Obesity is a disease of epidemic proportions, associated with chronic inflammation in response to increased secretion of inflammatory cytokines originating in adipose tissue. Exercise has been shown to be effective in combating these changes. The aim of this study was to review the anti-inflammatory effect of physical exercise in the pathogenesis of obesity. We conducted a search of the terms “exercise”, “obesity” and “inflammation” on Medline and PubMed databases, restricting results to clinical trials published since 2011. The retrieved studies showed that physical exercise could, via different pathways, reduce levels of CRP, IL-6 and TNF-α, as well as other proinflammatory markers. Additionally, exercise was able to increase expression of genes related to the production of nitric oxide, positively modulating endothelial function and chronic inflammation in obese patients, with or without caloric restriction. In conclusion, aerobic exercise of moderate intensity is an effective intervention strategy for chronic inflammation associated with obesity.

Sahel Afforestation and Simulated Risks of Heatwaves and Flooding Versus Ecological Revegetation That Combines Planting and Succession

Studies simulating the large-scale afforestation of the African Sahel constantly find warning signals of increased risk of extreme temperatures and heatwaves resulting from changes in albedo and latent heat flow. We review the afforestation measures underlying three simulation studies, together with a restoration model in which compartments are formed by greenbelts to enable succession of savanna vegetation, protected from hot wind and drought. Savanna-like vegetation (around 20% woody plants) will show bright reflective surface and drying of leaves during dry season rather than constant green color, with very different impact on albedo and temperatures. We derive that the simulated risks of extreme heat and flooding from rain will strongly depend on species, shape and density of the new vegetation. Ecological restoration concepts are expected to mitigate or prevent such restoration related climatic risks. Compact afforestation of the Sahel does not appear to be necessary or feasible. A restoration model based on compartmentalization and the protected succession of diverse, climatically adaptable vegetation could also be used in populated drylands, as a sustainable and temperature balancing solution to desertification.

Intestinal Microbiota, Obesity and Insulin Resistance—What Are the Relationships?

Obesity is a public health problem and its prevalence increases every year, resulting from a complex interaction between genetic, metabolic and environmental factors, as well as cultural influences. The Intestinal Microbiota is composed of trillions of microorganisms by forming a symbiotic relationship with the host and helping the absorption of various nutrients, increasing the extraction of components of the diet, the lipogenesis and intestinal permeability. Studies show that there is difference between the composition of the intestinal microbiota of an obese person and a healthy one. The purpose of this article is to review the literature on the relationship between the Intestinal Microbiota, Obesity and Insulin Resistance and also illustrate some studies on the subject.

Polycystic Ovary Syndrome and the Role of Metformin in Ovulation Induction

The Polycystic Ovary Syndrome (PCOS) is frequently associated with comorbidities such as obesity, reduced glucose tolerance, hypertension, macrovascular disease and dyslipidemia. The Metabolic syndrome occurs in 30% of women with PCOS. Metformin has increasingly been used in this therapy due to its effects in reducing insulin resistance. Treatment of PCOS aims to reduce the symptoms of hyperandrogenism, regularize the menstrual cycle, reduce metabolic abnormalities, and lower the risk of type 2 diabetes mellitus and of cardiovascular disease. Additionally it is important to prevent hyperplasia and endometrial cancer, and to offer contraception to those who do not wish pregnancy, and to help to induce ovulation to those who do. The effectiveness of metformin in this treatment is assessed in the light of the current best evidence.

Properties of Entropy and Entanglement of Two—Mode Nonlinear Coherent States

In this communication, two-mode nonlinear coherent states are reviewed and special cases are given.Starting from a three-level atom coupled to two modes of radiation with any form of nonlinearities of the two-modefields, we derive a Raman-coupled effective Hamiltonian by a unitary transformation, evaluated perturbatively in couplingconstants. We use the quantum entropy to measure the degree of entanglement in the time development of an effectivetwo-level atom interacting with two-mode nonlinear-coherent states. The results show that the nonlinearity effect yieldsthe superstructure of atomic Rabi oscillations and the effect of the Stark shift changes the quasiperiod of the field entropyevolution and entanglement between the particle and the field. A possible experimental test of a new effect is proposed.

Growth Hormone Replacement Therapy in Patients without Adult Growth Hormone Deficiency: What Answers Do We Have So Far?

Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) have been suggested as “anti-aging” therapies, or for improving quality of life with aging. In this study, we focus on the actions of GH in the main organs and organ systems of the human body, like skeletal muscle, bones and brain, particularly in regard to data and research on the use of GH replacement therapy in adults without growth hormone deficiency, especially elderly patients. Several different studies have been carried out to show what the effects and side effects of GH replacement in healthy people and what would be the impact in quality of life and life span. In this review, we demonstrate what answers we have so far about the effects of GH replacement in many organs and systems in healthy people.

The Role of States in Controlling the Obesity Epidemic, and a Personal Autonomy to Decide

Obesity has reached pandemic proportions in the world. Who is to blame for this: the person or the State (or both?). An increase in diseases associated with excess weight is also worldwide reported, such as Diabetes, Hypertension and some types of cancers. Therefore, the economic impacts of these comorbidities are an important issue to be discussed by States and citizens. Although the World Health Organization (WHO) has set and classified obesity as a disease more than 30 years ago, the American Medical Society was until recently (2010) not so sure about this definition. This article discusses the relevance of the implementation of public health policies for prevention and control of obesity, along with the possible ethical limitations to these actions, considering the autonomy of individuals regarding their health.

Pathophysiology of Graves’ Ophthalmopathy: A Literature Review

Graves’ ophthalmopathy (GO), an autoimmune condition associated with Graves’ disease (GD), occurs at a prevalence of nearly 40% in patients diagnosed with GD. Ocular involvement is probably due to the presence of autoantibodies in the orbital tissues, regardless of the control state of thyroid hormones in individuals with GD, even during euthyroid or hypothyroid states, which are associated with thyroid hormone treatment. In addition to the immunological role present in the pathophysiology of GO, the genetic component, proteins and cytokines, minerals (e.g., selenium), and environmental factors (e.g., smoking) also contribute to its development and occurrence of clinical manifestations in varying degrees. Until now, the interaction of causal, intermediary, and triggering factors of GO is still unclear, so the purpose of this article is to review literature on the theme.

Populational Description of Patients with Diabetes Mellitus Attended in a Family Health Center in Cuiabá, Mato Grosso

Diabetes mellitus (DM) represents one of the most serious current health problems nowadays, considering the number of people affected, its complications and morbidities. A broad analysis was performed among diabetic patients attended in the Family Health Center from the district of Baú, in Cuiabá, Mato Grosso State (Center-east Brazil), to examine the patterns of occurrence of overweight or obesity, values of glycated hemoglobin and the diagnostic of metabolic syndrome. The results show ahead a wide work that is necessary to prevent and early diagnose concerning DM, since only an intensive control will make it possible to alter the reality of the unfavorable prognosis documented.

The Role of Fructose in Public Health and Obesity

We are in the so-called nutritional transition, in which obesity and its comorbidities have emerged as an important research topic, and the information on food composition is fundamental to promote nutritional safety. Fructose is the sweetest carbohydrate, and this sweetness, along with its low cost, is the key factor for its use in commercial drinks and sweets. The global average consumption of fructose per capita has increased from 56 g/day in 1986 to 65 g/day in 2007. Experimental models associate high fructose intake with the development of obesity and induced insulin resistance. In recent studies, diabetic patients have been reported to use fructose more frequently than glucose. Fructose acts differently in the hypothalamus and generates less satiety than glucose;thus, fructose has a high lipogenic potential. Replacing fructose with another isocaloric carbohydrate is associated with better glycemic control.

Endocrine Disruptors and Fetal Programming

The concept “fetal programming” shows who still in the intrauterine life, can interfere in factors related to the genesis and development of diseases in childhood, adolescence and adult life. The literature shows that children born to mothers with gestational diabetes mellitus (GDM) are at increased risk for the development of obesity in adulthood, it becomes fundamental to study more about the subject. Obesity is a disease of multifactorial etiology, resulting from complex interactions between genetic and environmental factors. However, the marked increase in its incidence, precocity and severity are not yet fully understood. Several findings suggest that stressor stimuli (e.g. diabetes, nutritional changes) during intrauterine development may promote epigenetic changes, as well as affect mitochondrial metabolism, which may modulate fetal development and predispose to the late development of diseases. Despite the considerable amount of evidence accumulated about intrauterine programming for diseases of adult life, the determinant mechanisms of such programming are not yet clear.

Dunnigan-Type Familial Partial Lipodystrophy: Understanding and Treating the Syndrome

Dunnigan-type partial lipodystrophy, which is characterized by a number of metabolic alterations, change in body fat distribution, and autosomal dominant inheritance pattern, is rare in the general population. Objective: To report the case of an adolescent with clinical and laboratory findings suggestive of Dunnigan-type partial lipodystrophy. Methods: Case report and literature review. Results: A 15-year-old adolescent presented at the clinic complaining of darkening of skin folds on her trunk and back. During physical examination, the presence of serious acanthosis nigricans in her cervical region, axillae, and intergluteal space was noted. Hirsutism in androgen-dependent areas was also observed, as well as relevant reduction of subcutaneous adipose tissue in the limbs, gluteal region, abdomen, and trunk and fat accumulation in the face and chin. Discussion. Dunnigan-type familial partial lipodystrophy is a rare dominant autosomal disease resulting from a heterozygous missense mutation in the LMNA gene, known as LPF type 2 (Dunnigan variant), which encodes the nuclear protein A/C-type lamin. It is characterized by the progressive disappearance of the subcutaneous adipose tissue in the limbs, gluteal region, abdomen, and trunk, with onset in puberty, followed by fat accumulation in other areas such as the face, chin, labia majora, and intra-abdominal region, leading to hypertrophy that may mimic the Cushing’s syndrome phenotype. Affected patients display marked insulin resistance and may consequently develop diabetes mellitus, acanthosis nigricans, hirsutism, and polycystic ovary syndrome. Conclusion: This case report highlights the importance of suspecting Dunnigan-type familial partial lipodystrophy in clinical practice. Early clinical diagnosis allows for measures that minimize the severe metabolic disorders associated with this disease and, consequently, these adolescents’ self-esteem issues.

Graves’Disease and Marine Lenhart Syndrome:A Rare Clinical Presentation

The aim of this study is to review and discuss the clinical features and treatment options for the Marine-Lenhart syndrome, an uncommon thyroid disturb. The methodology adopted was a bibliographic research. The results of this study show that different mechanisms are implicated in the pathogenesis of Graves’ disease and in the nodular formation of thyroid tissue with functional autonomy. Graves’ disease is caused by an autoimmune process that involves the entire thyroid gland and is characterized by the presence of TSH receptor stimulating antibodies. The present study concludes that caution should be exercised in interpreting thyroid disease in Graves’ disease. The treatment of thyrotoxicosis requires high doses of oral drugs. Relapsing antithyroid therapy occurs soon after oral antithyroid therapy is discontinued. This presentation should alert the physician about the existence of toxic nodules, and about the possibility of a Marine-Lenhart Syndrome.

On the calibration of rotational augmentation models for wind turbine load estimation by means of CFD simulations

In this work the improved version of an engineering model which accounts for rotational augmentation effects by means of computational fluid dynamics(CFD)calibration is explored and discussed.Based on an analysis of the NREL Phase VI wind turbine,the novel modeling is presented,which uses as base line the formulation proposed by Chaviaropoulos and Hansen.The model is calibrated based on CFD simulations using OpenFOAM.The corresponding correction of the two dimensional polars is straightforward implemented within MoWiT,an in-house software for load calculation.The novel formulation results in improved lift and drag coefficients prediction in all considered cases,reducing the deviation with respect to the rotating CFD cases down to few percent.The optimal configuration including the correction for tip effects of Shen shows better agreements at the very tip of the blade.Furthermore the range of applicability for large wind turbine rotor blades based on a virtual 10MW rotor model is discussed.

In vitro biodegradation testing of Mg-alloy EZK400 and manufacturing of implant prototypes using PM(powder metallurgy)methods

The study is focussing towards Metal Injection Moulding (MIM) of Mg-alloys for biomedical implantapplications. Especially the influence of the sintering processing necessary for the consolidation of thefinished part is in focus of this study. In doing so, the chosen high strength EZK400 Mg-alloy powdermaterial was sintered using different sintering support bottom plate materials to evaluate the possibilityof iron impurity pick up during sintering. It can be shown that iron pick up took place from the steelbottom plate into the specimen. Despite the fact that a separating boron nitrite (BN) barrier layer wasused and the Mg-Fe phase diagram is not predicting any significant solubility to each other. As a result ofthis study a new bottom plate material not harming the sintering and the biodegradation performance ofthe as sintered material, namely a carbon plate material, was found.

喉罩和气管导管在经皮扩张气管造口术中的应用：气管内结构可见度的对比

目的在经皮扩张气管造口（pefcutaneous dilatational tracheostomy，PDT）过程中，由于气管结构暴露不良，导致一些严重的并发症。从主观上来说，通过喉罩（1aryngeal mask airway，LMA）行纤维支气管镜检查比通过气管导管（endotracheal tube，ETT）行纤维支气管镜检查其视野显示更充分。本前瞻性随机研究旨在比较LMA及EIT在PDT过程中，气管结构显示的清晰程度，同时报道lOT中通气质量及气道相关并发症。方法本研究中，接受PDT的患者33例使用LMA，30例使用ETT。通气质量及气管结构（甲状软骨、环状软骨、气管软骨）的可视程度分为4级：很好（1级）；较好（2级）；困难（3级）；无法通气或看见（4级）。评分为4级的患者需要更换通气方法。组间比较使用X2检验。结果LMA组的气管结构可见度更高：LMA组94％为1级或2级，而ETT组仅有66％为1级或2级（P〈0．05）。LMA组患者气管穿刺过程中97％的患者视野显示为1级或2级，而ETT组仅有77％（P〈0．05）。LMA组及ETT组分别有1例和3例患者评分为4级。两组的血流动力学变化相似。两组均存在PDT过程中Pa02的下降及PaCO2的上升，但是ETT组PaCO2的上升更为显著（59±14mmHg及51±11mmHg，P〈0．05）。ETF组2例患者气管导管不慎滑脱，另1例患者因气管穿刺位置显示不清导致纤维支气管镜损坏。结论与EIT相比，LMA在气管结构的可视程度及PUF扩张中具有明显优点。特别是对于缺乏经验的重症监护人员或是解剖结构复杂的患者而言，良好的显露使得操作条件更优化。