Significance It is established that glucose tolerance decreases from the morning to the evening, and that shift work is a risk factor for diabetes. However, the relative importance of the endogenous ...circadian system, the behavioral cycle (including the sleep/wake and fasting/feeding cycles), and circadian misalignment on glucose tolerance is unclear. We show that the magnitude of the effect of the endogenous circadian system on glucose tolerance and on pancreatic β-cell function was much larger than that of the behavioral cycle in causing the decrease in glucose tolerance from morning to evening. Also, independent from circadian phase and the behavioral cycle, circadian misalignment resulting from simulated night work lowered glucose tolerance—without diminishing effects upon repeated exposure—with direct relevance for shift workers.
Glucose tolerance is lower in the evening and at night than in the morning. However, the relative contribution of the circadian system vs. the behavioral cycle (including the sleep/wake and fasting/feeding cycles) is unclear. Furthermore, although shift work is a diabetes risk factor, the separate impact on glucose tolerance of the behavioral cycle, circadian phase, and circadian disruption (i.e., misalignment between the central circadian pacemaker and the behavioral cycle) has not been systematically studied. Here we show—by using two 8-d laboratory protocols—in healthy adults that the circadian system and circadian misalignment have distinct influences on glucose tolerance, both separate from the behavioral cycle. First, postprandial glucose was 17% higher (i.e., lower glucose tolerance) in the biological evening (8:00 PM) than morning (8:00 AM; i.e., a circadian phase effect), independent of the behavioral cycle effect. Second, circadian misalignment itself (12-h behavioral cycle inversion) increased postprandial glucose by 6%. Third, these variations in glucose tolerance appeared to be explained, at least in part, by different mechanisms: during the biological evening by decreased pancreatic β-cell function (27% lower early-phase insulin) and during circadian misalignment presumably by decreased insulin sensitivity (elevated postprandial glucose despite 14% higher late-phase insulin) without change in early-phase insulin. We explored possible contributing factors, including changes in polysomnographic sleep and 24-h hormonal profiles. We demonstrate that the circadian system importantly contributes to the reduced glucose tolerance observed in the evening compared with the morning. Separately, circadian misalignment reduces glucose tolerance, providing a mechanism to help explain the increased diabetes risk in shift workers.
The aim of the present study was to examine the association between polymorphism in the catechol-O-methyltransferase(COMT) gene and Alzheimer's disease (AD) in a Brazilian population. The ...case-control method was used to study the association between AD and genetic variants of COMT. Six tag single-nucleotide polymorphisms(SNPs) in the COMT gene were genotyped by RT-PCR. Our findings showed that the 6 tag SNPs analyzed in this study were not associated with AD at the allele and genotype levels in comparison with the control group. No statistical difference was found between groups with and without behavioral and psychological symptoms of dementia (BPSD). Our results do not support the hypothesis that the polymorphisms of the COMT gene may be associated with susceptibility to AD with and without BPSD.
Higher risk of dementia is expected for patients with late onset depression (LOD) history. The IL-10 polymorphisms are associated with Alzheimer disease (AD). On the other hand, there is no study ...associating IL-10 polymorphisms to LOD. This study aimed to investigate the −1082G/A polymorphism association in LOD, AD patients and controls and also the peripheral expression of IL-10 in CD4+ T cells. It was done in a case–control study comparing immune system phenotype and genetic polymorphism association among control individuals, LOD and AD patients. Participants were 569 subjects composed the genetics sample (249 AD, 222 LOD and 98 controls) from a tertiary medical center based on Belo Horizonte, Brazil. Flow cytometry analysis was performed in 55 people (22 AD patients, 11 LOD patients and 22 controls). A real time PCR for IL-10 SNP (rs 1800896) through genotyping analysis and flow cytometry evaluation of CD4+ T cells expressing IL-10 was done. An increased CD4+ T cells expressing IL-10 were detected only in the AD group. There was no difference detected in allele or genotype analysis for IL-10 polymorphism among LOD, AD patients or controls. IL-10 might have a role in the modulation of immune response in AD patients, however it is not presented in LOD population.
•Higher % of T cells expressing IL-10 in AD patients compared to controls•IL-10 polymorphism was not associated among LOD or AD patients or controls.•Relation of IL-10 polymorphisms and serum levels in AD remains to be studied.
Introduction: Robotic surgery has become increasingly accessible and is already a reality worldwide. Although several medical specialties have benefited from this technology, urology is the one that ...has most incorporated the use of robots into surgical procedures. When we talk about robotic surgery, many patients imagine that a robot is used to carry out the procedure autonomously. It must be made clear that it is the surgeon who controls the robot and that this equipment only reproduces the movements of the doctors hands. Methodology: This article is a systematic review, based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology, which seeks to identify the most widely used types of robotic surgery today, their advantages and disadvantages. Literature review: It is important for centers that apply robotics to follow standardized training, improve reporting and increase patient education in order to reduce errors related to robotic surgery. Robotic surgery should be performed by urological surgeons trained in robotics and with extensive experience in robotic and laparoscopic surgery. It should also not be forgotten that adding robots to the surgical equation can create room for error in an area that is already complex and full of risks. Final thoughts: Robotic surgery is getting better and better as more advanced robots are developed to overcome existing shortcomings. Patients should therefore expect better results from robot-assisted surgery as advanced machines are applied.
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