•Histopathological changes and the increase in serum creatinine and BUN induced by cisplatin were ameliorated by berberine.•Berberine significantly reduced the increase in renal CYP2E1, 4-HNE, 3-NT ...and HO-1 expression.•The expression of NF-κB, TNF-α and COX-2 in the kidneys was markedly suppressed by berberine.•Treatment with berberine reduced the expression of p53, cleaved caspase-3 and LC3B in the kidneys.•Berberine inhibited renal oxidative stress, inflammation, apoptosis and autophagy induced by cisplatin.
The aim of this study was to investigate the therapeutic activity of isoquinoline alkaloid berberine against cisplatin (CP)-induced nephrotoxicity in mice. Berberine was administered at daily doses of 1, 2 and 3mg/kg by gavage for two successive days, 48h after intraperitoneal CP injection (13mg/kg). Mice were sacrificed 24h after the last dose of berberine. Histopathological changes and the increase in serum creatinine and blood urea nitrogen (BUN) induced by CP were significantly ameliorated by berberine in a dose-dependent manner. Additionally, oxidative/nitrosative stress, evidenced by the increase in renal 4-hydroxynonenal (4-HNE), 3-nitrotyrosine (3-NT), cytochrome P450 E1 (CYP2E1) and heme oxygenase (HO-1) expression, was significantly reduced. The expression of nuclear factor-kappaB (NF-κB), tumor necrosis factor-α (TNF-α), cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) was markedly suppressed by berberine, indicating the inhibition of inflammatory response. Treatment of CP-intoxicated animals with berberine also significantly reduced the expression of p53, active caspase-3 as well as autophagy marker light chain 3B (LC3B) in the kidneys. The results of the current study showed the nephroprotective activity of berberine against CP-induced renal injury, which could be attributed to the inhibition of oxidative/nitrosative stress, inflammation, autophagy and apoptosis.
•Rosmarinic acid ameliorated increased serum creatinine and blood urea nitrogen in cisplatin-intoxicated mice.•The increase in renal 4-hydroxynonenal, cytochrome P450 2E1 and heme oxygenase-1 ...expression was significantly reduced.•Rosmarinic acid inhibited the expression of pro-inflammatory nuclear factor-kappaB and tumor necrosis factor-alpha.•Rosmarinic acid reduced the expression of p53, phosphoserine-15 p-p53 and active caspase-3 in the kidneys.
Rosmarinic acid (RA) is a natural phenolic compound with a broad range of applications, from food preservatives to cosmetics. Increasing amounts of evidence suggests its beneficial effects against various pathological conditions. The aim of this study was to investigate the therapeutic activity of rosmarinic acid (RA) against cisplatin (CP)-induced nephrotoxicity. RA was administered by oral gavage at doses of 1, 2 and 5mg/kg for two successive days, 48h after intraperitoneal CP injection (13mg/kg). Twenty four hours later, mice were sacrificed. Treatment with RA significantly ameliorated histopathological changes and the increase in serum creatinine and blood urea nitrogen (BUN) induced by CP. Oxidative stress induced by CP, evidenced by increased renal 4-hydroxynonenal (4-HNE), cytochrome P450 2E1 (CYP2E1) and heme oxygenase (HO-1) expression, was significantly reduced by RA administration. Moreover, RA inhibited the expression of nuclear factor-kappaB (NF-κB) and tumor necrosis factor-α (TNF-α), indicating the inhibition of inflammation. Additionally, RA exhibited antiapoptotic activity through the reduction of p53, phosphorylated p53 and active caspase-3 expression in the kidneys. These findings show that RA ameliorates CP-induced oxidative stress, inflammation and apoptosis in the kidneys. The nephroprotective activity of RA could be, at least in part, attributed to reduced CYP2E1 expression.
Background
The intragastric balloon is a widely used method in the treatment of obesity indicated for those patients who have failed to achieve and maintain the weight loss with conventional measures ...or for preparation of patients who are candidates for bariatric surgery.
Methods
From April 2007 to April 2009, 171 consecutive patients (111 females, 60 males; mean age 39.2 ± 10.5, mean weight 123.2 ± 27.1 kg) were evaluated before and 6 months after bioenteric intragastric balloon (BIB) placement by assessment of anthropometric and biochemical parameters.
Results
The mean BMI during balloon treatment declined from 41.9 ± 7.3 to 36.0 ± 7.9 kg/m
2
(
p
< 0.001) with a percentage of excess weight loss of 39.7 ± 23.6 and percentage of excess body mass index loss of 39.5 ± 25.1. A significant improvement in blood pressure, glycemia, and triglyceride level but not in total cholesterol, high-density lipoprotein, and low-density lipoprotein cholesterol levels was seen.
Conclusion
Results of this large prospective single center study confirmed that intragastric balloon is useful and safe method for promoting weight loss. Due to improvement of metabolic parameters, treatment with BIB results in reduction of cardiovascular risk and provides a sustained benefit on liver function in obese patients.
Abstract
Objective: To determine thresholds of maternal glycemia at which specific adverse pregnancy outcomes occur in high-risk population.
Methods: A total of 1002 pregnant women with risk factors ...for gestational diabetes mellitus (GDM) underwent an originally modified glucose tolerance test (OGTT) with 75 g of glucose. Information on OGTT results and pregnancy outcomes were collected from database and medical records.
Results: Large for gestational age (LGA) newborn, infant's stay in the neonatal intensive care unit (NICU) >24 h, neonatal hyperbilirubinemia and cesarean section due to cephalopelvic disproportion were identified as specific GDM adverse outcomes. In the study group of participants with one or more specific GDM adverse outcomes, mean glycemic values during the modified OGTT (4.2 ± 1.0 mmol/L at 0 min, 6.8 ± 1.7 mmol/L at 30 min, 7.9 ± 2.1 mmol/L at 60 min, 7.7 ± 2.3 mmol/L at 90 min and 7.5 ± 2.3 mmol/L at 120 min) according to Student's t-test for independent samples were significantly higher than mean glycemic values in the control group of participants without specific adverse outcomes (p < 0.001, p = 0.02, p < 0.001, p < 0.001, p < 0.001).
Conclusion: This study provides additional data that support the acceptance of the newly recommended outcome-based GDM diagnostic criteria.
Hiponatrijemija je najčešći poremećaj metabolizma tjelesnih tekućina i ravnoteže elektrolita u kliničkoj praksi. Prisutna je u oko 15 – 30 % hospitaliziranih pacijenata, a može se očitovati širokim ...spektrom kliničkih promjena, od vrlo blagih do po život opasnih. Hiponatrijemija je primarno poremećaj ravnoteže vode, obično uz relativni višak tjelesne vode u usporedbi s ukupnim tjelesnim sadržajem natrija i kalija. Hiponatrijemija ovisno o vremenu nastanka može biti akutna (< 48 h) ili kronična (≥ 48 h). S obzirom na vrijednost serumske koncentracije natrija razlikujemo blagu hiponatrijemiju (Na(s) 130 – 135 mmol/l), zatim umjerenu ili srednje tešku (Na(s) 125 – 129 mmol/l) i tešku hiponatrijemiju (Na(s) < 125 mmol/l). U pristupu pacijentu s hiponatrijemijom od životne je važnosti ustanoviti radi li se o akutnim, teškim simptomima hiponatrijemije, kako bi se na vrijeme počelo s terapijskim mjerama koncentriranom 3 % otopinom NaCl. U slučaju izostanka ovih simptoma, dijagnostički algoritam nas usmjerava prema određenim diferencijalno dijagnostičkim entitetima ovisno o vrijednosti urinske osmolalnosti i koncentracije Na u urinu, kako bi terapija bila što točnija i odgovarajuća uzročnom faktoru hiponatrijemije.
Hitna stanja u endokrinologiji predstavljaju skupinu po život opasnih stanja koja često,
unatoč dijagnostičkim i terapijskim dostignućima suvremene medicine, i dalje ostaju često
neprepoznata. ...Nepravovremena dijagnoza i odgođeni početak liječenja dodatno pridonose
ionako visokoj smrtnosti koja karakterizira ova stanja. Iako se najčešće javljaju u osoba
s otprije poznatim endokrinopatijama, hitno stanje može biti i prva manifestacija bolesti endokrinog
sustava, što dodatno otežava pravovremeno postavljanje dijagnoze. U ovom preglednom
članku iznosimo prikaz najčešćih hitnih stanja u endokrinologiji i dijabetologiji u
okrilju medicine zasnovane na dokazima. Dijabetička ketoacidoza (DKA) i hiperglikemijsko
hiperosmolarno stanje (HHS) dvije su najčešće akutne komplikacije šećerne bolesti koje
ujedno predstavljaju i najčešća hitna stanja u endokrinologiji. Tireotoksična kriza, miksedemska
koma i adrenalna kriza nisu stanja s kojima se često susrećemo u kliničkoj praksi, no
važno je prepoznati ih na vrijeme i započeti sa specifičnim liječenjem jer u protivnom rezultiraju
ozbiljnim komplikacijama i visokom smrtnošću. Poznavajući činjenicu da su hitna stanja
u endokrinologiji često posljedica drugih bolesti ili stanja, sve precipitirajuće poremećaje
treba prepoznati i liječiti.
Osteoporoza je metabolička bolest kosti karakterizirana gubitkom koštane mase i poremećenom
mikroarhitekturom koštanog tkiva, što za posljedicu ima povećanu krhkost kostiju i povećan rizik za ...nastanak prijeloma. Osnovni mehanizam nastanka osteoporoze je gubitak ravnoteže između koštane razgradnje i stvaranja nove kosti. Dijagnostički kriterij za osteoporozu
je smanjena mineralna gustoća kosti za 2,5 standardne devijacije u odnosu na vršnu gustoću
kosti (zdrave 30-godišnjakinje), utvrđeno denzitometrijom. Iako preventivne mjere, kao što su primjena kalcija, vitamina D, tjelovježba i reduciranje čimbenika rizika, trebaju biti sastavni dio pristupa bolesniku s osteoporozom, kako bi se postigla primjerena zaštita od prijeloma, u većine bolesnika potrebno je primijeniti i farmakološku terapiju. Nekoliko je lijekova dostupno za terapiju osteoporoze. Prema osnovnom mehanizmu djelovanja na kost klasificiraju se kao antiresorptivni ili osteoanabolički lijekovi. Antiresorptivni lijekovi u prvom redu smanjuju koštanu
resorpciju, dok anabolici potiču stvaranje nove kosti. Ovaj članak donosi pregled lijekova koji se trenutno primjenjuju u liječenju osteoporoze, kao i budućih terapijskih opcija.
There is a need for better understanding and research of the comorbidity structure in schizophrenia and bipolar disorder.
To assess the prevalence of somatic and psychiatric comorbidity in ...schizophrenia and bipolar affective disorder treated at the University Hospital Centre Zagreb.
This retrospective study compares the prevalence of comorbid diagnosis of somatic and psychiatric disorders in 192 patients with schizophrenia and 97 patients with bipolar disorder. The diagnoses were established according to ICD-10 criteria. The data were collected from hospital medical documentation.
Patients with bipolar disorder had more both somatic (67.1% vs. 50.6%) and psychiatric (29.9% vs. 10.9%) comorbidity than patients with schizophrenia. The three most prevalent somatic comorbidites in patients with bipolar disorders were cardiovascular (22.6%), endocrinological (22.6%), and gastrointestinal (16.4%) disorders while neurological (11.4%), gastrointestinal (10.9%) and endocrinological (9.3%) disorders were the most frequent in patients with schizophrenia.
The exact prevalence and nature of the somatic and psychiatric comorbidity in patients with schizophrenia and bipolar disorder is still unclear and further research is needed.
34-year old patient had history of muscular wasting, easy fatigability, pain in extremities and waddling gait since age of four. During the time, neuromuscular disease was suspected, but not ...confirmed. Elevated bone alkaline phosphatase as well as other bone turnover markers (osteocalcin, procollagen, telopeptide) indicated further skeletal evaluation. Symmetrical enhanced uptake on technetium methylene diphosphonate 99mTcMPD bone scintigraphy at diaphyses of longitudinal bones and scull matched cortical thickening of long bones and sclerosis of the scull seen at radiograms. Those findings pointed to Camurati-Engelmann disease misdiagnosed for the long time. This rare genetic autosomal dominant disorder was retrospectively diagnosed in asymptomatic father too on the basis of bone scans done long time ago. Old family member scans confirmed heredity pattern of the disease.
PDF
