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Liraglutide exerts an anti-inflammatory action in obese patients with type 2 diabetes

Abstract

Introduction. Liraglutide (L) is the analogue of human glucagon-like peptide 1 which stimulates glucose-dependent insulin secretion and can modify the level of inflammatory biomarkers.

L can influence NF-kB inflammatory cascade, but the mechanisms of anti-inflammatory activities of L remain to be determined. In animal models L influenced an activity of Sirtuin 1(SIRT1). Moreover, recent evidences strongly suggest that SIRT1 up-regulation may serve as a potent therapeutic approach against development and progression of diabetic complications. The aim of this study was to investigate L effects directed on the pro-inflammatory NF-kB pathway and expression of SIRT1 in obese patients with type 2 diabetes mellitus (DM).

Materials and Methods. 15 obese patients with type 2 diabetes were studied, all using metformin (1-2 g/day) and sulfonylurea (glimiperide). All patients received L 1.2 mg daily add-on to stable therapy for 6 weeks. Blood samples were collected before, 6 weeks after start of treatment and after an overnight fast 6 weeks after stopping L, mononuclear cells (MNC) were isolated. The mRNA expressions of TNF-α, TLR2, TLR4, NOD1, IL-2 and SIRT1 were measured in MNC by RT-PCR. Ceruloplasmin concentration was measured in plasma by photometric method.

Results. In this add-on pilot clinical investigation we received new data that L can inhibit proinflammatory NF-kB pathway by increased SIRT1 expression in obese patients with type 2 DM improving metabolic profile. The mRNA expression in MNC of TNF-α, IkB, TLR2, TLR4, and plasma ceruloplasmin fell after 6 weeks of L. Expressions of IL-2 and NOD-1 were stable. There was a significant increase of SIRT1 mRNA expression. The mRNA expression in MNC of TNF-α, IkB, TLR2, TLR4, NOD1, SIRT1 and ceruloplasmin concentrations did not reverse to baseline levels after 6 weeks stopping of L treatment. IL-2 expression decreased in comparison with basic level.

Conclusions. L has a potent anti-inflammatory effect as do GLP-1 agonists due to inhibition of NF-kB pathways and up-regulate SIRT1 expression, down-regulating pro-inflammatory factors including cytokines (TNF-α), extra- and intracellular receptors (TLR2, TLR4), and inflammation markers such as ceruloplasmin. Long lasting effects of L can be mediated by epigenetic regulation of NF-kB pathway by SIRT-1.

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Medical evaluation and management of male and female voiding dysfunction: a review

-302. 61. KUO, H.C., Videourodynamic characteristics and lower urinary tract symptoms of female bladder outlet obstruction. Urology, 2005. 66 (5): p. 1005-9. 62. AKBAL, C., et al ., Dysfunctional voiding and incontinence scoring system: quantitative evaluation of incontinence symptoms in pediatric population. J Urol, 2005. 173 (3): p. 969-73. 63. AFSHAR, K., et al ., Development of a symptom score for dysfunctional elimination syndrome. J Urol, 2009. 182 (4 Suppl): p. 1939-43. 64. SINHA, S., Dysfunctional voiding: A review of the terminology

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Non-alcoholic fatty pancreas disease – practices for clinicians

F, MAHFUD M et al. The role of "fatty pancreas" and of BMI in the occurrence of pancreatic fistula after pancreaticoduodenectomy. J. Gastrointest. Surg., 2009; 13 (10): 1845-1851. 28. TOMITA Y, AZUMA K, NONAKA Y, KAMADA Y, TOMOEDA M, KISHIDA M et al. Pancreatic fatty degeneration and fibrosis as predisposing factors for the development of pancreatic ductal adenocarcinoma . Pancreas 2014; 43 (7): 1032-1041. 39. CATANZARO R., CUFFARI B., ITALIA A., MAROTTA F. Exploring the metabolic syndrome: Nonalcoholic fatty pancreas disease. World

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Current state of the use of musculoskeletal ultrasound (MSUS) and view on the future development of MSUS training and services in Hong Kong: Results of a survey among the members of the Hong Kong Society of Rheumatology

establish the current state of the use of MSUS and the members’ view on the future development of MSUS training and services in Hong Kong. 2 Methods 2.1 Study design A three-page English language anonymous questionnaire was sent either in electronic format or hardcopy to 79 members (70 full members and 9 ordinary members) of the Hong Kong Society of Rheumatology. The survey ran from March until May 2015. The aim is to inquire about the use of MSUS by rheumatologists and their views on the future development of MSUS training and service in Hong Kong. After

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Evolution of Psychosomatic Diagnosis in DSM. Historical Perspectives and New Development for Internists

Abstract

The so-called “Psychosomatic symptoms” represent a real challenge for internists. These have often been described as non-specific, non-organic, functional, dysfunctional or idiopathic. These “diagnostic puzzles” are obviously difficult to treat. Psychosomatic symptoms have been categorized as hysteria, psychogenic, psychosomatic, conversion, somatization and somatoform disorder. It is only when modern classificatory systems such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD) were developed that research was stimulated and new clinical developments became much stronger than any other time. The current paper is aimed at briefly presenting the evolution of psychosomatic symptoms in DSM while pointing out the major milestones as well as the benefits and challenges along the way. We discuss the perspectives open with the advent of the 5th edition the DSM-V.

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Development of a curriculum and training program in Woman Veterans Health for Internal Medical Residents

Abstract

Introduction. Internal Medicine residents must develop competency as Primary Care Providers, but a gap exists in their curriculum and training with regard to women’s reproductive health. With increasing need in VA due to new influx of women veterans it poses problems in recruitment of competent physicians trained in Women’s health. Methods. An intensive, one-month women’s reproductive health curriculum with hands on experience for Internal Medicine residents was provided. Curriculum was taught to the residents who rotated at the Women’s Health Clinic for one month. Pre-test and post-test exams were administered. Increase in knowledge of residents in providing gender specific evaluations and management was objectively assessed by changes in post-test scores. Data were analyzed for statistically significant improvement in written tests scores. Results. Total of 47 Internal Medicine residents rotated through Women’s Health Center during the evaluation period. All residents completed both pre-test and post-test exams. The average time to complete the pre-test was 20.5 ± 5.4 min and 19.5 ± 4.8 min for post-test. There was no correlation between the time to complete the pre-test exam and the post-test exam. The total score was significantly improved from 8.5 ± 1.6 to 13.2 ± 1.8 (p < 0.0001). Conclusion. This study shows how to equip physicians in training with information on women’s health that enables them to provide safe and gender appropriate care in primary care settings. This practice will reduce the need for frequent referrals for specialized care and thus provide cost saving for patient and health care on the whole.

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Atrial fibrillation: A review of modifiable risk factors and preventive strategies

(8):1217-22. doi:10.1016/j.amjcard.2014.07.045. 49. GOUDIS CA, KORANTZOPOULOS P, NTALAS IV, KALLERGIS EM, LIU T, KETIKOGLOU DG. Diabetes mellitus and atrial fibrillation: Pathophysiological mechanisms and potential upstream therapies . International journal of cardiology. 2015; 184 :617-22. doi:10.1016/j.ijcard.2015.03.052. 50. RIX TA, JOENSEN AM, RIAHI S, LUNDBYE-CHRISTENSEN S, TJONNELAND A, SCHMIDT EB et al. A U-shaped association between consumption of marine n-3 fatty acids and development of atrial fibrillation/atrial flutter-a Danish cohort

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Downregulation of tumor-suppressor gene LHX6 in cancer: a systematic review

REFERENCES 1. GRIGORIOU M., TUCKER AS., SHARPE PT., PACHNIS V. Expression and regulation of Lhx6 and Lhx7, a novel subfamily of LIM homeodomain encoding genes, suggests a role in mammalian head development . Development. 1998; 125 (11):2063-2074. 2. ESTÉCIO MRH., YOUSSEF EM., RAHAL P., FUKUYAMA EE., GÓIS-FILHO JF., MANIGLIA JV., et al . LHX6 is a sensitive methylation marker in head and neck carcinomas . Oncogene. 2006; 25 :5018-5026. 3. PERRENOUD Q., GEOFFROY H., GAUTHIER B., RANCILLAC A., ALFONSI F., KESSARIS N., et al. Characterization

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Management of immune-related adverse events in patients treated with immune checkpoint inhibitors– Rheumatology point of view

loss of normal regulation leads to autoimmunity and various immune-related adverse events (irAEs). 1 Ipilimumab, a CTLA-4 inhibitor, was first approved by the Food and Drug Administration in 2011 for the treatmentof late-stage melanoma. Since then, the development of immunotherapy has been thriving and became part of the standard oncology care. The indications of anti-cytotoxic T-lymphocyte-associated antigen 4 (anti-CTLA-4), anti-programmed cell death protein (anti-PD1), and anti-programmed cell death protein ligand (anti-PDL1) now extend from melanoma to non

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Liver Fibrosis: Causes and Methods of Assessment, A Review

: 817-825. 9. YANG JD, NAKAMURA I, ROBERTS LR. The tumor microenvironment in hepatocellular carcinoma: Current status and therapeutic targets. Semin Cancer Biol 2012; 21 : 35-43. 10. ZHAO W, ZHANG L, YIN Z, SU W, REN G, ZHOU C, YOU J, FAN J, WANG X. Activated hepatic stellate cells promote hepatocellular carcinoma development in immunocompetent mice . Int J Cancer 2011; 129 : 2651-2561. 11. KANG N, YAQOOB U, GENG Z, BLOCH K, LIU C, GOMEZ T, BILLADEAU D, et al. Focal adhesion assembly in myofibroblasts fosters a microenvironment that promotes

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