Evaluation of community pharmacist follow-up supported by the use of healthcare technology for type 2 diabetes patients

Background

Prevalence of type 2 diabetes is high in Belgium (estimated at over 10%, 1 patient out of 3 being unaware of their diagnosis). Management based on a change of lifestyle and the adoption of health-promoting behaviors, supplemented when needed with drug treatment, prevents complications, improves the patient's quality of life and reduces mortality. Multidisciplinary patient support is essential. In this, pharmacists have a key role, e.g. through therapeutic patient education activities, in which they are increasingly involved. Moreover, research suggests that the use of mobile technologies can be a useful tool for helping patients with their daily life and disease management.

Objectives

This study aims at exploring the benefits of community pharmacist follow-up supported by the use of mobile technologies in the monitoring of individuals with type 2 diabetes. The presented intervention aimed to reinforce the patients' willingness to actively participate in the management of their disease and to adopt favorable health behaviors, in order to increase their level of medication adherence.

Methods

A quantitative quasi-experimental study was conducted in community pharmacies throughout Belgium over a 6-month period with 3 data collection periods (before, during and after the intervention). Primary outcomes, related to the level of medication adherence, and secondary outcomes, considered as markers of the patient's overall health, were analyzed. In addition, qualitative data concerning participants' opinions on their experience were collected.

Results

66 patients participated in the study, with 50 remaining after 3 months and 46 completing the entire study. Statistical analyses did not show an improvement in the level of medication adherence. This parameter was high from the beginning, reflecting patients with controlled diabetes. However, statistically significant results were observed for systolic blood pressure and waist circumference (both improved), while other outcomes showed a positive trend or remained stable. Patient follow-up by the pharmacist was a positive experience for both parties which noted their interest and satisfaction for the project.

Conclusions

Although clinical results are not conclusive, patients were motivated and the attrition rate was low. Participants showed their interest in participating in this kind of project, opening up opportunities for further studies in the community pharmacy setting. As front-line health professionals, community pharmacists certainly have a key-role to play in therapeutic patient education and mobile technologies could be additional tools in this process.

Pilot scale validation campaign of gel dosimetry for pre-treatment quality assurance in stereotactic radiotherapy

PURPOSE

Complex stereotactic radiotherapy treatment plans require prior verification. A gel dosimetry system was developed and tested to serve as a high-resolution 3D dosimeter for Quality Assurance (QA) purposes.

MATERIALS AND METHODS

A modified version of a polyacrylamide polymer gel dosimeter based on chemical response inhibition was employed. Different sample geometries (cuvettes and phantoms) were manufactured for calibration and QA acquisitions. Irradiations were performed with a Varian Trilogy linac, and analyses of irradiated gel dosimeters were performed via MRI with a 1.5 T Philips Achieva at 1 mm3 or 2 mm3 isotropic spatial resolution. To assess reliability of polymer gel data, 54 stereotactic clinical treatment plans were delivered both on dosimetric gel phantoms and on the Delta4 dosimeter. Results from the two devices were evaluated through a global gamma index over a range of acceptance criteria and compared with each other.

RESULTS

A quantitative and tunable control of dosimetric gel response sensitivity was achieved through chemical inhibition. An optimized MRI analysis protocol allowed to acquire high resolution phantom dose data in timeframes of ≈ 1 h. Conversion of gel dosimeter data into absorbed dose was achieved through internal calibration. Polymer gel dosimeters (2 mm3 resolution) and Delta4 presented an agreement within 4.8 % and 2.7 % at the 3 %/1 mm and 2 %/2 mm gamma criteria, respectively.

CONCLUSIONS

Gel dosimeters appear as promising tools for high resolution 3D QA. Added complexity of the gel dosimetry protocol may be justifiable in case of small target volumes and steep dose gradients.

Determination of Total Dietary Fiber (CODEX Definition) by Enzymatic-Gravimetric Method and Liquid Chromatography: Collaborative Study

A method for the determination of total dietary fiber (TDF), as defined by the CODEX Alimentarius, was validated in foods. Based upon the principles of AOAC Official MethodsSM 985.29, 991.43, 2001.03, and 2002.02, the method quantitates high- and low-molecular-weight dietary fiber (HMWDF and LMWDF, respectively). In 2007, McCleary described a method of extended enzymatic digestion at 37C to simulate human intestinal digestion followed by gravimetric isolation and quantitation of HMWDF and the use of LC to quantitate low-molecular-weight soluble dietary fiber (LMWSDF). The method thus quantitates the complete range of dietary fiber components from resistant starch (by utilizing the digestion conditions of AOAC Method 2002.02) to digestion resistant oligosaccharides (by incorporating the deionization and LC procedures of AOAC Method 2001.03). The method was evaluated through an AOAC collaborative study. Eighteen laboratories participated with 16 laboratories returning valid assay data for 16 test portions (eight blind duplicates) consisting of samples with a range of traditional dietary fiber, resistant starch, and nondigestible oligosaccharides. The dietary fiber content of the eight test pairs ranged from 11.57 to 47.83. Digestion of samples under the conditions of AOAC Method 2002.02 followed by the isolation and gravimetric procedures of AOAC Methods 985.29 and 991.43 results in quantitation of HMWDF. The filtrate from the quantitation of HMWDF is concentrated, deionized, concentrated again, and analyzed by LC to determine the LMWSDF, i.e., all nondigestible oligosaccharides of degree of polymerization 3. TDF is calculated as the sum of HMWDF and LMWSDF. Repeatability standard deviations (sr) ranged from 0.41 to 1.43, and reproducibility standard deviations (sR) ranged from 1.18 to 5.44. These results are comparable to other official dietary fiber methods, and the method is recommended for adoption as Official First Action.

A Coordinated Action of Blood-Borne and Brain Insulin-Like Growth Factor I in the Response to Traumatic Brain Injury

In response to injury, the brain produces different neuroprotective molecules, such as insulin-like growth factor I (IGF-I). However, IGF-I is also taken up by the brain from the circulation in response to physiological stimuli. Herein, we analyzed in mice the relative contribution of circulating and locally produced IGF-I to increased brain IGF-I levels after insult. Traumatic brain injury (TBI) induced by a controlled impact resulted in increased IGF-I levels in the vicinity of the lesion, but mice with low serum IGF-I showed significantly lower increases. Indeed, in normal mice, peripheral IGF-I accumulated at the lesion site after injury, and at the same time serum IGF-I levels decreased. Collectively, these data suggest that serum IGF-I enter into the brain after TBI and contributes to increased brain IGF-I levels at the injury site. This connection between central and circulating IGF-I provides an amenable route for treatment, as subcutaneous administration of IGF-I to TBI mice led to functional recovery. These latter results add further support to the use of systemic IGF-I or its mimetics for treatment of brain injuries.

Insulin Peptides as Mediators of the Impact of Life Style in Alzheimer's disease

The search for the cause of Alzheimer's disease (AD), that affects millions of people worldwide, is currently one of the most important scientific endeavors from a clinical perspective. There are so many mechanisms proposed, and so disparate changes observed, that it is becoming a challenging task to provide a comprehensive view of possible pathogenic processes in AD. Tauopathy (intracellular neurofibrillary tangles) and amyloidosis (extracellular amyloid plaques) are the anatomical hallmarks of the disease, and the formation of these proteinaceous aggregates in specific brain areas is widely held as the ultimate pathogenic mechanism. However, the triggers of this dysproteostasis process remain unknown. Further, neurofibrillary tangles and plaques may only constitute the last stages of a process of still uncertain origin. Thus, without an established knowledge of its etiology, and no cure in the horizon, prevention - or merely delaying its development, has become a last-resort goal in AD research. As with other success stories in preventive medicine, epidemiological studies have provided basic knowledge of risk factors in AD that may contribute to understand its etiology. Disregarding old age, gender, and ApoE4 genotype as non preventable risk factors, there are diverse life-style traits - many of them closely related to cardiovascular health, that have been associated to AD risk. Most prominent among them are diet, physical and mental activity, exposure to stress, and sleep/wake patterns. We argue that all these life-style factors engage insulinergic pathways that affect brain function, providing a potentially unifying thread for life-style and AD risk. Although further studies are needed to firmly establish a link between faulty insulinergic function and AD, we herein summarize the evidence that this link should be thoroughly considered.

Circulating insulin-like growth factor I modulates mood and is a biomarker of vulnerability to stress: from mouse to man

Individual susceptibility to anxiety disorders after maladaptive responses to stress is not well understood. We now report that while exploring stress responses in mice after traumatic brain injury (TBI), a condition associated to stress susceptibility, we observed that the anxiogenic effects of either TBI or exposure to life-threatening experiences (predator) were blocked when both stressors were combined. Because TBI increases the entrance into the brain of serum insulin-like growth factor I (IGF-I), a known modulator of anxiety with a wide range of concentrations in the human population, we then determined whether circulating IGF-I is related to anxiety measures. In mice, anxiety-like responses to predator were inversely related to circulating IGF-I levels. Other indicators of mood regulation such as sensitivity to dexamethasone suppression and expression levels of blood and brain FK506 binding protein 5 (FKBP5), a co-chaperone of the glucocorticoid receptor that regulates its activity, were also associated to circulating IGF-I. Indeed, brain FKBP5 expression in mice was stimulated by IGF-I. In addition, we observed in a large human cohort (n = 2686) a significant relationship between plasma IGF-I and exposure to recent stressful life events, while FKBP5 expression in blood cells was significantly associated to plasma IGF-I levels. Collectively, these data indicate that circulating IGF-I appears to be involved in mood homeostasis across different species. Furthermore, the data in mice allow us to indicate that IGF-I may be acting at least in part by modulating FKBP5 expression.

Hypothyroidism and hyperthyroidism change ectoenzyme activity in rat platelets

The purinergic system has an important role in the regulation of vascular functions. The interference of thyroid hormones in this system and in cardiovascular events has been studied in recent years. However, the mechanisms involved in vascular, purinergic, and oxidative changes in thyroid disorders are not completely understood. Therefore, the present study aimed to assess purinergic enzyme activity in platelets from rats with hypothyroidism and hyperthyroidism induced, respectively, by continuous exposure to methimazole (MMI) at 20 mg/100 mL or L-thyroxine at 1.2 mg/100 mL in drinking water for 1 month. Results showed that rats exposed to L-thyroxine had a significant decrease in NTPDase activity, wherein ATP hydrolysis was 53% lower and ADP hydrolysis was 40% lower. Moreover, ecto-5'-nucleotidase activity was decreased in both groups, by 39% in the hypothyroidism group and by 52% in the hyperthyroidism group. On the other hand, adenosine deaminase (ADA) activity was increased in hyperthyroidism (75%), and nucleotide pyrophosphatase/phosphodiesterase (NPP) activity was increased in animals with hypothyroidism (127%) and those with hyperthyroidism (128%). Our findings suggest that changes in purinergic enzyme and purine levels could contribute to the undesirable effects of thyroid disturbances. Moreover, oxidative stress and, in particular, a high level of ROS production, showed a causal relation with changes in ectonucleotidase activity and nucleotide and nucleoside levels.

A method to identify the areas at risk for the introduction of avian influenza virus into poultry flocks through direct contact with wild ducks

Wild dabbling ducks are the main reservoir for avian influenza (AI) viruses and pose an ongoing threat to commercial poultry flocks. Combining the (i) size of that population, (ii) their flight distances and (iii) their AI prevalence, the density of AI-infected dabbling ducks (DID) was calculated as a risk factor for the introduction of AI viruses into poultry holdings of Emilia-Romagna region, Northern Italy. Data on 747 poultry holdings and on 39 AI primary outbreaks notified in Emilia-Romagna between 2000 and 2017 were used to validate that risk factor. A multivariable Bayesian logistic regression was performed to assess whether DID could be associated with the occurrence of AI primary outbreaks. DID value, being an outdoor flock, hobby poultry trading, species reared, length of cycle and flock size were used as explanatory variables. Being an outdoor poultry flock was significantly associated with a higher risk of AI outbreak occurrence. The probability of DID to be a risk factor for AI virus introduction was estimated to be 90%. A DID cut-off of 0.23 was identified to define high-risk areas for AI virus introduction. Using this value, the high-risk area covers 43% of the region. Seventy-four per cent of the primary AI outbreaks have occurred in that area, containing 39% of the regional poultry holdings. Poultry holdings located in areas with a high DID value should be included in a risk-based surveillance programme aimed at AI early detection.

Circulating Insulin-Like Growth Factor I Regulates Its Receptor in the Brain of Male Mice

The role of IGF-1 and its receptor (IGF-1R) in brain pathology is still unclear. Thus, either reduction of IGF-IR or treatment with IGF-1, two apparently opposite actions, has proven beneficial in brain diseases such as Alzheimer's dementia. A possible explanation of this discrepancy is that IGF-1 down-regulates brain IGF-1R levels, as previously seen in a mouse Alzheimer's dementia model. We now explored whether under normal conditions IGF-1 modulates its receptor. We first observed that in vitro, IGF-1 reduced IGF-1R mRNA levels in all types of brain cells including neurons, astrocytes, microglia, endothelial cells, and oligodendrocytes. IGF-1 also inhibited its own expression in neurons and brain endothelium. Next, we analyzed the in vivo actions of IGF-1. Because serum IGF-1 can enter the brain, we injected mice with IGF-1 ip. As soon as 1 hour after the injection, decreased hippocampal IGF-1 levels were observed, followed by increased IGF-1 and IGF-1R mRNAs 6 hours later. Because environmental enrichment (EE) stimulates the entrance of serum IGF-1 into the brain, we analyzed whether a physiological entrance of IGF-1 also produced changes in brain IGF-1R. Stimulation of IGF-1R by EE triggered a gradual decrease in hippocampal IGF-1 levels. After 6 hours of EE exposure, IGF-1 levels reached a significant decrease in parallel with increased IGF-1R expression. After longer times, IGF-1R mRNA levels returned to baseline. Thus, under nonpathological conditions, IGF-1 regulates brain IGF-1R. Because baseline IGF-1R levels are rapidly restored, a tight control of brain IGF-1R expression seems to operate under physiological conditions.

Early biochemical biomarkers for zinc in silver catfish (Rhamdia quelen) after acute exposure

Contamination of aquatic ecosystems by metals causes various biochemical changes in aquatic organisms, and fish are recognized as indicators of environmental quality. Silver catfish were exposed to six concentrations of zinc (Zn): 1.0, 2.5, 5.0, 7.5, 10.0 and 12.5 mg/L for 96 h to determine the mean lethal concentration (LC50). The value obtained was 8.07 mg/L. In a second experiment, fish were exposed to concentrations of 1.0 or 5.0 mg/L Zn and a control for 96 h. Afterward, the tissues were collected for biochemical analysis. Lipid peroxidation, as indicated by thiobarbituric acid-reactive substance (TBARS), decreased in the liver and brain for all Zn concentrations tested, while in the gills TBARS levels increased at 1.0 mg/L and declined at 5.0 mg/L. Zn increased protein carbonyls in the muscle of silver catfish and decreased it in the other tissues. The enzyme superoxide dismutase increased in both exposed groups. However, catalase did not change. Glutathione S-transferase decreased in the liver and increased in the gills (1.0 mg/L), muscle (5.0 mg/L) and brain (1.0 and 5.0 mg/L). Nonprotein thiols changed only in brain and muscle tissue. Zn exposure inhibited acetylcholinesterase (AChE) activity in the brain at both concentrations tested, but did not change it in muscle. Exposure to Zn inhibited the activity of Na(+)/K(+)-ATPase in the gills and intestine at both concentrations tested. Our results demonstrate that Zn alters biochemical parameters in silver catfish and that some parameters such as AChE and Na(+)/K(+)-ATPase could be considered as early biomarkers of waterborne Zn toxicity.

Effects of quercetin on oxidative stress biomarkers in methimazole - induced hypothyroid rats

The objective of the present study was to evaluate the effect of quercetin on oxidative stress biomarkers in methimazole (MMI) - induced hypothyroidism male rats. Hypothyroidism was induced by administering MMI at 20 mg/100 ml in the drinking water, for 1 month. After achieved hypothyroidism, rats received orally 10 or 25 mg/kg of quercetin (QT) for 8 weeks. 60 male wistar rats were randomly divided into 6 groups (group I, control; group II, QT10; group III, QT25; group IV, hypothyroid; group V, hypothyroid+QT10; group VI, hypothyroid+QT25). Liver, kidney and serum TBARS levels significantly increased in hypothyroid rats when compared to controls, along with increased protein carbonyl (PCO) in liver and increased ROS levels in liver and kidney tissues. QT10 and QT25 were effective in decreasing TBARS levels in serum and kidney, PCO levels in liver and ROS generation in liver and kidney. MMI - induced hypothyroidism also increased TBARS levels in cerebral cortex and hippocampus that in turn were decreased in rats treated with QT25. Moreover, the administration of QT25 to hypothyroid rats resulted in decreased SOD activities in liver and whole blood and increased liver CAT activity. Liver and kidney ascorbic acid levels were restored with quercetin supplementation at both concentrations. QT10 and QT25 also significantly increased total oxidative scavenging capacity in liver and kidney tissues from hypothyroid rats. These findings suggest that MMI - induced hypothyroidism increases oxidative stress parameters and quercetin administration could exert beneficial effects against redox imbalance in hypothyroid status.

Evaluation of the effects induced by dietary diphenyl diselenide on common carp Cyprinus carpio

Several diets employed in aquaculture are enriched with selenium (Se), as it is a fundamental element to aquatic vertebrates. Diphenyl diselenide [(PhSe)₂], which is a synthetic organoselenium compound, has been considered a potential antioxidant agent in different experimental models. Thus, the aim of this study was to evaluate the effects of dietary diphenyl diselenide at concentrations of 1.5, 3.0, and 5.0 mg/kg for 60 days and to determine its optimal supplemental level for carp, Cyprinus carpio. Neither growth retardation nor hepatoxicity was induced by the inclusion of diphenyl diselenide at concentrations ranging from 1.5 to 5.0 mg/kg. In addition, the inclusion of 3.0 mg/kg of diphenyl diselenide stimulated the weight and length of the carp. The supplementation with 1.5 and 3.0 mg/kg of diphenyl diselenide did not produce oxidative damage in the tissues, verified by peroxidation lipid and protein carbonyl assays. However, at 5.0 mg/kg, it caused an increase of the lipid peroxidation in the liver, brain, and muscle, and inhibited the cerebral acetylcholinesterase activity. An increase of the hepatic superoxide dismutase activity and non-protein thiols content in all tissues and ascorbic acid in the liver, gills, and brain was verified in carp fed with the diet containing 3.0 mg/kg of diphenyl diselenide. This diet had advantageous effects for the fish used in experiments. Therefore, this compound could be considered a beneficial dietary supplement for carp nutrition.

Alterations in carbohydrate and protein metabolism in silver catfish (Rhamdia quelen) exposed to cadmium

Changes in carbohydrate and protein metabolism were studied in silver catfish Rhamdia quelen exposed to cadmium (0; 0.236 or 0.414 mg/L) during 7 and 14 days. After exposure time the fish were exposed to recovery period (water without cadmium), during 7 and 14 days. Different alterations in the metabolic parameters were observed such as an increase in lactate, protein, amino acid and ammonia levels as well as a reduction in glucose values after the exposure periods in liver. In muscle, glycogen and glucose values enhanced after cadmium exposure at both concentrations for 7 days; however, at 0.414 mg/L cadmium, protein levels decreased while amino acids and ammonia levels enhanced. An increase in the lactate values was found in plasma after 7 days of exposure and a reduction in the lactate, glucose and protein levels occurred after 14 days of exposure. Results indicated that the metabolic alterations after cadmium exposure were dependent on the tissue type and exposure time. Cadmium exposure for 14 days and recovery period also of 14 days seem to be less harmful to the liver and muscle. However, even after recovering from some changes, fish health may be affected making them more sensitive to some environmental changes.

Toxic effects of penoxsulam herbicide in two fish species reared in southern Brazil

Toxic effects of penoxsulam herbicide on acetylcholinesterase, thiobarbituric acid-reactive substances and protein carbonyl were studied in silver catfish (Rhamdia sp.) and carp (Cyprinus carpio). Acetylcholinesterase activity was inhibited in both brain and muscle tissue, with the inhibition being greater in carp than in silver catfish. The levels of malondialdehyde (MDA), an indicator of lipid peroxidation, decreased in silver catfish brain tissue, but increased in the carp brain. MDA also increased significantly in muscle tissue of silver catfish. The levels of protein carbonyl, another measure of oxidative damage, increased in the brain of both fish species, and in the muscle of carp. However, silver catfish exhibited a decrease in muscle protein carbonyl. It appears that silver catfish may possess better mechanisms of defense against penoxsulam toxicity than carp.

Comparative study on effects of dietary with diphenyl diselenide on oxidative stress in carp (Cyprinus carpio) and silver catfish (Rhamdia sp.) exposed to herbicide clomazone

The study investigated the capacity of diphenyl diselenide [(PhSe)2] (3.0mg/kg), on reduce the oxidative damage in liver, gills and muscle of carp and silver catfish exposed to clomazone (192h). Silver catfish exposed to clomazone showed increased thiobarbituric acid-reactive substance (TBARS) in liver and muscle and protein carbonyl in liver and gills. Furthermore, clomazone in silver catfish decrease non-protein thiols (NPSH) in liver and gills and glutathione peroxidase and ascorbic acid in liver. (PhSe)2 reversed the effects caused by clomazone in silver catfish, preventing increases in TBARS and protein carbonyl. Moreover, NPSH and ascorbic acid were increased by values near control. The results suggest that (PhSe)2 attenuated the oxidative damage induced by clomazone in silver catfish. The clomazone no caused an apparent situation of oxidative stress in carp, showing that this species is more resistant to this toxicant. Altogether, the containing (PhSe)2 diet helps fish to increase antioxidants defenses.

The effects of diphenyl diselenide on oxidative stress biomarkers in Cyprinus carpio exposed to herbicide quinclorac (Facet®)

The occurrence of pollutants in the aquatic environment can produce severe toxic effects on non-target organisms, including fish. These sources of contamination are numerous and include herbicides, which represent a large group of toxic chemicals. Quinclorac, an herbicide widely applied in agriculture, induces oxidative stress due to free radical generation and changes in the antioxidant defense system. The aim of this study was to assess if dietary diphenyl diselenide (PhSe)₂ has a protective effect in tissues of fish species Cyprinus carpio exposed to the quinclorac herbicide. The fish were fed with either a standard or a diet containing 3.0 mg/Kg of diphenyl diselenide for 60 d. After were exposed to 1 mg/L of Facet® (quinclorac commercial formulation) for 192 h. At the end of the experimental period, parameters as thiobarbituric acid-reactive substance levels (TBARS), protein carbonyl, catalase (CAT), superoxide dismutase (SOD), glutathione S-transferase (GST), nonprotein thiols (NPSH) and ascorbic acid in the liver, gills, brain and muscle were evaluated in Cyprinus carpio. In fish exposed to quinclorac and feeding with standard diet TBARS levels increased in liver and gills. However, SOD activity decreases in liver whereas no alterations were observed in catalase activity in this tissue. Quinclorac also decrease GST activity in liver and brain, NPSH in brain and muscle and ascorbic acid in muscle. Concerning protein carbonyl exposed to herbicide the fish did not show any alterations. The diphenyl diselenide supplemented diet reversed these effects, preventing increases in TBARS levels in liver and gills. GST activity was recovered to control values in liver. NPSH levels in brain and muscle increased remain near to control values. These results indicated that dietary diphenyl diselenide protects tissues against quinclorac induced oxidative stress ameliorating the antioxidant properties.

Association of lipids with oxidative stress biomarkers in subclinical hypothyroidism

Objective. The aim of the present study was to evaluate the oxidative stress biomarkers in patients with subclinical hypothyroidism (n = 20) and health controls (n = 20). Subjects and Methods. Total cholesterol (TC), triglycerides (TGs), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), thiobarbituric acid reactive substances (TBARSs), catalase (CAT), superoxide dismutase (SOD), and arylesterase (ARE) were analyzed. Results. TC, LDL-C, TBARS, and CAT were higher in subclinical hypothyroidism patients, whereas SOD did not change. Arylesterase activity was significantly lower in the SH group, compared with the control group. Correlation analyses revealed the association of lipids (TC and LDL-C) with both oxidative stress biomarkers and thyrotropin (TSH). Thyroid hormones were correlated only with triglyceride levels. In addition, TSH was significantly correlated with TBARS, CAT, and SOD. However, no significant correlations were observed after controlling TC levels. Conclusions. We found that SH patients are under increased oxidative stress manifested by reduced ARE activity and elevated lipoperoxidation and CAT activity. Secondary hypercholesterolemia to thyroid dysfunction and not hypothyroidism per se appears to be associated with oxidative stress in subclinical hypothyroidism.

Toxicological responses of Cyprinus carpio exposed to a commercial formulation containing glyphosate

The effects of commercial glyphosate herbicide formulation on the activity of acetylcholinesterase (AChE) enzyme and oxidative stress were studied in Cyprinus carpio exposed for 96 h to 0.0, 0.5, 2.5, 5.0 and 10.0 mg/L and then allowed to equal recovery period in water without herbicide. The activity of AChE was inhibited in the brain and in the muscle after exposure. However, after recovery period brain and muscle AChE activity increased. Brain thiobarbituric acid reactive species (TBARS) were measured as an indicator of oxidative stress. Increased TBARS levels were observed with all concentrations tested of the glyphosate formulation, and remained increased after the recovery period. The results recorded clearly indicate lipid peroxidation and anti-AChE action induced by Roundup(®) exposure.

Roundup effects on oxidative stress parameters and recovery pattern of Rhamdia quelen

Antioxidant enzymes and oxidative stress indicators were evaluated in fish exposed to different concentrations of the herbicide Roundup 48% (Monsanto, St. Louis, MO): control (none), 0.45, or 0.95 mg/l. After exposure for 8 days to herbicide, fish were transferred to clean water for a recovery response period (also 8 days). Herbicide increased thiobarbituric acid reactive species in liver and muscle at the higher concentration and in the brain at both concentrations. Protein carbonyl in liver increased after exposure. Catalase (CAT) and superoxide dismutase (SOD) activities and ascorbic acid levels in liver did not change in fish exposed to both concentrations. Glutathione S-transferase (GST) levels decreased at both concentrations. The nonprotein thiol levels decreased at the 0.95 mg/l concentration. During the recovery period, some of the parameters that had altered, such as protein carbonyl content, later recovered. However, some enzymes reacted during this period, e.g., GST increased its activity, possibly indicating a compensatory response against the toxic conditions. In contrast, CAT and SOD activities decreased during the recovery period, indicating herbicide toxicity. Oxidative stress that occurred during the exposure period was likely due to the increased lipid peroxidation and protein carbonyl content. The results concerning oxidative and antioxidant profiles indicate that short-term exposure to herbicide is capable of causing oxidative stress in fish tissues.

Benzydamine as a useful substrate of hepatic flavin-containing monooxygenase activity in veterinary species

Benzydamine (BZ), a weak base and an indazole derivative with analgesic and antipyretic properties used in human and veterinary medicine, is metabolized in human, rat, cattle and rabbit to a wide range of metabolites. One of the main metabolites, BZ N-oxide (BZ-NO), is produced in the liver and brain by flavin-containing monooxygenases (FMOs), by liver and brain enzymes. To evaluate the suitability of BZ as an FMO probe in veterinary species, BZ metabolism was studied in vitro using liver microsomes from bovine, rabbit and swine. Kinetic parameters, K(m) and V(max), of BZ-NO production, were evaluated to corroborate the pivotal role of FMOs. Inhibition studies were carried out by heat inactivation and by specific FMO chemical inhibitors: trimethylamine and methimazole. The results confirmed the presence of FMO activity in the liver and the role of BZ as a suitable marker of FMO enzyme activities for the veterinary species considered.

Oxidative stress biomarkers in Cyprinus carpio exposed to commercial herbicide bispyribac-sodium

Cyprinus carpio were exposed under field conditions to 20.87 microg l(-1) of commercial herbicide bispyribac-sodium (Nominee, SC), during 7, 21 and 72 days. Enzymatic parameters such as catalase (CAT), glutathione S-transferase (GST) and acetylcholinesterase (AChE) activities, as well as thiobarbituric acid-reactive substances (TBARS) and protein carbonyl contents were studied in different tissues. After 7 days of exposure, GST activity decreased. At the same period, brain AChE activity increased, but a reduction of activity was observed in muscle tissue. Brain TBARS levels increased at 7 days. After 21 days of exposure liver CAT levels and muscle AChE activities decreased. In the same period, liver protein carbonyl and muscle TBARS increased. After 72 days of exposure in the field, AChE activity was reduced in both brain and muscle. Protein carbonyl contents in liver and brain TBARS levels increased. Muscle AChE activity, TBARS and protein carbonyl can be used as biomarkers of exposure to the herbicide bispyribac-sodium. This study demonstrates effects of exposure to bispyribac-sodium under rice field conditions on oxidative stress parameters in tissues of Cyprinus carpio.

Exposure to tebuconazol in rice field and laboratory conditions induces oxidative stress in carp (Cyprinus carpio)

Pesticides can have an effect on the biochemical and physiological functions of living organisms. The changes seen in fish and their response to pesticides can be used as an example for vertebrate toxicity. In this study, carp fish (Cyprinus carpio) were exposed to different concentrations of tebuconazol fungicide, by rice field (31.95 μg/L) and laboratory (33.47 and 36.23 μg/L) conditional testing, during a 7 day period. Parameters such thiobarbituric acid-reactive substance levels (TBARS), protein carbonyl, catalase, glutathione S-transferase and acetylcholinesterase activities were studied, using the liver, brain and white muscle of the fish. The field experiment showed that the TBARS levels were increased in all the analyzed tissues. Similarly, the protein carbonyl of the liver and the brain AChE activity increased after 7 days. The laboratory experiment demonstrated that the TBARS levels in the liver were increased in both of the concentration tests. TBARS levels in the muscle increased only by the lowest test concentration. On the other hand, the protein carbonyl was increased only by the highest concentration. The results indicate that the tebuconazol exposure from the field and laboratory conditions directly affected the health of the fish, showing the occurrence of oxidative stress.

Association between thyroid hormones, lipids and oxidative stress biomarkers in overt hypothyroidism

BACKGROUND

The aim of this study was to investigate the effect of hypothyroidism on lipid peroxidation and the antioxidant profile, as well as to evaluate the interaction between thyroid hormones and biomarkers of oxidative stress in patients with overt hypothyroidism. We also evaluated the influence of cholesterol concentrations on biomarkers of oxidative stress in these same patients.

METHODS

Total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, thiobarbituric acid reactive substances (TBARS), superoxide dismutase (SOD), catalase (CAT), and vitamin E were measured in 20 subjects with overt hypothyroidism (OH) and 20 controls.

RESULTS

TC, LDL cholesterol, triglycerides, TBARS, SOD, CAT, and vitamin E were significantly higher in the OH group. Significant correlation was observed for TSH and SOD, CAT, vitamin E and TBARS. Correlation was observed for triiodothyronine (T3) and SOD, CAT, vitamin E and TBARS. Significant correlation was also observed for free thyroxine and vitamin E and TBARS. However, correlation between T3 and CAT remained significant after controlling for TC concentrations.

CONCLUSIONS

Overt hypothyroidism is associated with an increase in oxidative stress, and hypercholesterolemia has a stronger influence on development of oxidative stress in hypothyroid conditions compared with thyroid hormones.

The role of physical identity of the sample and correct comparison stimulus in matching-to-sample paradigms

Pigeons were trained in a higher-order conditional discrimination paradigm to assess the role of physical identity in a within-subjects design. A line orientation which was super-imposed on all response keys signalled whether a response to the matching color or a response to the nonmatching color was correct. Following training under this paradigm, stimulus control gradients were obtained by varying the angularity of the lines. Orderly gradients of stimulus control were obtained and no bias toward or away from the physically identical comparison stimulus was observed. The data were interpreted as indicating that the pigeons acquired a discrimination for each specific stimulus configuration or a set of specific stimulus-response chains based on compound stimuli in which physical identity played no special role.

Detection of West Nile virus infection in horses, Italy, September 2008

Six confirmed and five suspected cases of West Nile virus infection in horses have been reported in the vicinity of Ferrara in Italy. To verify the diffusion of viral circulation and to prevent the spread of disease, the regional authorities of Emilia-Romagna adopted a special plan of West Nile fever surveillance.

Bluetongue control using vaccines: the experience of Emilia Romagna, Italy

In 2003, thirty municipalities of the provinces of Parma, Reggio Emilia and Modena in the Emilia Romagna region of Italy, bordering the region of Tuscany, were included in the national bluetongue (BT) vaccination programme, using monovalent live-attenuated type 2 vaccine. The purpose of the study was to evaluate the organisation of a vaccination programme designed by the Regional Veterinary Service and the relative cost of the campaign, as a large number of animals were involved. To better evaluate the real cost of the campaign, costs sustained by the Reggio Emilia Local Sanitary Unit were specifically analysed. BT vaccination of all domestic ruminants is a very expensive operation (euro9.20 per vaccinated animal). Consequently, to evaluate the need for a vaccination campaign in a new area, the risk of disease spread, as well as the cost of the operation, should be considered.

Metabolism of tilmicosin by rabbit liver microsomes and hepatocytes

We investigated tilmicosin (TIM) metabolism, at 25, 50 or 100 microM, in cultures of primary hepatocytes from rabbits bred commercially for food and in liver microsomes prepared from both untreated and rifampicin (RIF)-treated rabbits. RIF is a well-known cytochrome P4503A (CYP 3A) inducer in rabbits and most macrolides are known to be substrates of CYP 3A. No peaks in addition to those of the cis and trans forms of TIM were observed by high performance liquid chromatography (HPLC) in extracts of microsomes from untreated rabbits. When TIM was incubated with induced microsomes, at least two peaks were found by HPLC and an additional peak, eluting at shorter retention time was isolated from hepatocytes incubated for 24h with the macrolide. The structures of the metabolites were then estimated by liquid chromatography-mass spectrometry (LC-MS) in concentrated extracts from induced microsomes. Five metabolites were separated and putatively identified: cis and trans demethylated tilmicosin, tilmicosin N-oxide and cis and trans tilmicosin epoxide. The overall amount of metabolites produced in vitro using livers of untreated and RIF treated rabbits was very low, has also been observed in vivo and in vitro in cattle, chickens and pigs.

Dynamic visual speech perception in a patient with visual form agnosia

To examine the role of dynamic cues in visual speech perception, a patient with visual form agnosia (DF) was tested with a set of static and dynamic visual displays of three vowels. Five conditions were tested: (1) auditory only which provided only vocal pitch information, (2) dynamic visual only, (3) dynamic audiovisual with vocal pitch information, (4) dynamic audiovisual with full voice information and (5) static visual only images of postures during vowel production. DF showed normal performance in all conditions except the static visual only condition in which she scored at chance. Control subjects scored close to ceiling in this condition. The results suggest that spatiotemporal signatures for objects and events are processed separately from static form cues.

Biotransformation of benzydamine by microsomes and precision-cut slices prepared from cattle liver

1. Benzydamine (BZ), a non-steroidal anti-inflammatory drug used in human and veterinary medicine, is not licensed for use in food-producing species. Biotransformation of BZ in cattle has not been reported previously and is investigated here using liver microsomes and precision-cut liver slices. 2. BZ was metabolized by cattle liver microsomes to benzydamine N-oxide (BZ-NO) and monodesmethyl-BZ (Nor-BZ). Both reactions followed Michaelis-Menten kinetics (Km = 76.4 +/- 16.0 and 58.9 +/- 0.4 microM Vmax = 6.5 +/- 0.8 and 7.4 +/- 0.5 nmolmg(-1) min(-1) respectively); sensitivity to heat and pH suggested that the N-oxidation is catalysed by the flavin-containing monooxygenases. 3. BZ-NO and Nor-BZ were the most abundant products derived from liver slice incubations, and nine other BZ metabolites were found and tentatively identified by LC-MS. Desbenzylated and hydroxylated BZ-NO analogues and a hydroxylated product of BZ were detected, which have been reported in other species. Product ion mass spectra of other metabolites, which are described here for the first time, indicated the formation of a BZ N- -glucuronide and five hydroxylated and N+-glucuronidated derivatives of BZ, BZ-NO and Nor-BZ. 4. The results indicate that BZ is extensively metabolized in cattle. Clearly, differences in metabolism compared with, for example, rat and human, will need to be considered in the event of submission for marketing authorization for use in food animals.

Pigeons' timing of an arbitrary and a naturalistic auditory stimulus: tone versus cooing

Previous animal research has traditionally used arbitrary stimuli to investigate timing in a temporal bisection procedure. The current study compared the timing of the duration of an arbitrary, auditory stimulus (a 500-Hz tone) to the timing of the duration of a naturalistic, auditory stimulus (a pigeon cooing). In the first phase of this study, temporal perception was assessed by comparing psychophysical functions for the duration of tone and cooing signals. In the first set of tests, the point of subjective equality (PSE) was significantly lower for the tone than for the cooing stimulus, indicating that tones were judged longer than equivalent durations of cooing. In the second set of tests, gaps were introduced in the tone signal to match those present in the cooing signal, and no significant difference in the PSE for the tone or the cooing signal was found. A repetition of the testing conducted with gaps removed from the tone signal, failed to replicate the difference in the PSEs for the tone and cooing signals originally obtained. In the second phase of the study, memory for the duration of tone and cooing was examined, and a choose-long bias was found for both signals. Based on these results, it appears that, for pigeons, there may be no significant differences in either temporal perception or temporal memory for arbitrary, auditory signals and more complex, naturalistic, auditory signals.

Effects of the dopamine D2 agonist, quinpirole, on time and number processing in rats

In Experiment 1, rats were trained to discriminate discrete sound sequences that varied in time or number. On time trials, the number of sounds was held constant at 4 and the duration of the sound sequence was either 2 or 8 s. On number trials, the duration of the sound sequence was held constant at 4 s, and the number of sounds was either 2 or 8. Psychophysical functions for time and number were obtained by presenting unreinforced sequences of intermediate duration or number. In agreement with previous research, sensitivity to variation in time was greater than variation in number. Rats received injections of the specific D2 agonist, quinpirole (0.08 mg/kg), or saline. Quinpirole significantly attenuated control by both time and number, but it did not increase behavioral estimates of time or number. In Experiment 2, rats were given different dosages of quinpirole (0.02, 0.04 or 0.06 mg/kg). The steepness of the psychophysical functions for both time and number was reduced in a dose-related fashion without any evidence of an increase in the estimation of time or number. The similarity of the effect of quinpirole on both time and number processing is consistent with the idea that the same internal mechanism is used for timing and counting. However, it is not consistent with the idea that D2 dopamine agonists selectively increase the rate of the internal clock, which is assumed to underlie performance in a temporal bisection procedure. Quinpirole (at doses between 0.02 and 0.08 mg/kg) reduces sensitivity to time and number in a bisection procedure without altering the speed of the internal clock.

Tylosin depletion in edible tissues of turkeys

The depletion of tylosin residues in edible turkey tissues was followed after 3 days of administration of tylosin tartrate at 500 mg l-1 in drinking water, to 30 turkeys. Immediately after the end of the treatment (day 0) and at day 1, 3, 5 and 10 of withdrawal, six turkeys (three males and three females) per time were sacrificed and samples of edible tissues were collected. Tissue homogenates were extracted, purified and analysed by HPLC according to a method previously published for the analysis of tylosin residues in pig tissues. In all tissues, tylosin residues were already below the detection limits of 50 micrograms kg-1 at time zero. However, in several samples of tissues (skin + fat, liver, kidney, muscle), from the six turkeys sacrificed at that time, one peak corresponding to an unknown tylosin equivalent was detected at measurable concentrations. The identification of this unknown compound was performed by LC-MS/MS analysis of the extracts from incurred samples. The mass fragmentation of the compound was consistent with the structure of tylosin D (the alcoholic derivative of tylosin A), the major metabolite of tylosin previously recovered and identified in tissues and/or excreta from treated chickens, cattle and pigs.

Biotransformation of genistein in the rat: elucidation of metabolite structure by product ion mass fragmentology

Biotransformation of the phytoestrogen [14C]genistein was investigated in male and female rats by application of narrow-bore radio-HPLC-MSn (LCQ, Finnigan) to determine intermediates in metabolism. Urine contained five metabolites, Gm1-Gm5, 24 h after dosing by gavage with [14C]genistein (4 mg kg(-1)). Structural analysis following ESI revealed molecular ions [M+H]+ of m/z 447, 449, 273, and 271 for metabolites Gm2, Gm3, Gm5 and genistein, respectively and an [M-H]- of m/z 349 for Gm4. Metabolite structure was deduced by evaluation of product ion spectra derived from unlabelled and [14C]-labelled ions and sensitivity to treatment with beta-glucuronidase. These studies indicated identity of metabolites with genistein glucuronide (Gm2), dihydrogenistein glucuronide (Gm3), genistein sulphate (Gm4) and dihydrogenistein (Gm5). Detection of the beta-glucuronidase resistant major metabolite Gm1 by ESI was poor and so was analysed by negative ion APCI; this revealed a deprotonated molecular ion of m/z 165 which had chromatographic and mass spectral properties consistent with authentic 4-hydroxyphenyl-2-propionic acid, a novel metabolite of genistein. In vitro metabolism studies with anaerobic caecal cultures derived from male and female rats revealed metabolism of genistein to Gm1 via Gm5 and an additional metabolite (Gm6) which was identified from product ion spectra as 6'-hydroxy-O-desmethylangolensin. Biotransformation of genistein by both isolated hepatocytes and precision-cut liver slices was limited to glucuronidation of parent compound. Commonality of genistein metabolites found in rats with those reported in man suggest similar pathways of biotransformation, primarily involving gut micro-flora.

Benign myoclonic epilepsy: long-term follow-up of 11 new cases

The authors report a long-term follow-up of 11 new subjects with benign myoclonic epilepsy. There were some unusual clinical features such as the need for dual therapy in 45.5% of subjects, and the presence of non-epileptic myoclonus in 54.5%, neither of which influenced the prognosis. Neuropsychological and behavioral evolution was less favorable in 45.5% of patients (mental retardation, school learning problems, attention deficit disorder, hyperkinesia, aggressiveness, irritability, negativism). The less favorable neuropsychological outcome might be related to additional interacting factors such as personal antecedents, seizure onset and antiepileptic treatment.

Familial Unverricht-Lundborg disease: a clinical, neurophysiologic, and genetic study

PURPOSE

Progressive myoclonus epilepsies (PMEs) are a clinically and etiologically heterogeneous group of disorders. The authors report clinical, neurophysiological, and genetic findings of a family from Southern Italy with three members affected with PME.

METHODS

All data about familial and personal antecedents, clinical history, neurologic examination, laboratory tests, neurophysiological findings, brain imaging studies, and DNA analysis were examined.

RESULTS

All results were compatible with the features of Unverricht-Lundborg disease and patients were homozygous for the "Finnish" ancestral haplotype.

CONCLUSIONS

Work is in progress to identify and characterize the common EPM1 mutation in the Finnish patients. Subsequently, it will be possible to verify the hypothesis on the existence of a common mutation in the Finnish patients and the Italian family under study, or even in other Mediterranean EPM1 families.

The effects of scopolamine on memory for time in rats and pigeons

In Experiment 1, pigeons were trained to match short (2 s) and long (8 s) sample durations to red and green comparison stimuli and red and green samples to vertical and horizontal line comparisons. They received injections of scopolamine hydrobromide (0.02 mg/kg), scopolamine methylbromide (0.02 mg/kg), or saline, and the delay interval was manipulated (0, 1, 3, and 9 s). In Experiment 2, rats were trained to discriminate short (2 s) or long (12 s) durations of house-light illumination using a choice procedure. During the test phase of each trial, the left and right levers were presented with the cue light on above one of them (cued lever) while the other was off (uncued lever). For half of the rats, the correct response following the short sample was to press the cued lever, whereas following the long sample, it was to press the uncued lever. This was reversed for the remaining rats. The rats received injections of scopolamine hydrobromide (0.15 mg/kg), scopolamine methylbromide (0.15 mg/kg), or saline, and the delay interval was manipulated (0, 1, 3, and 9 s). In pigeons, scopolamine equivalently disrupted both temporal and nontemporal memory. Memory for time, in both rats and pigeons, was significantly poorer following scopolamine injections than following methylscopolamine or saline injections. No choose-short effect was observed in either rats or pigeons during saline test sessions. The data indicate that central cholinergic blockade in both pigeons and rats disrupts the accuracy of delayed temporal discriminations. However, scopolamine does not appear to accelerate the rate at which memory for temporal events is foreshortened.

Gait analysis of the donor foot in microsurgical reconstruction of the thumb

Clinical and step evaluations by a piezoelectric system board were performed in 54 patients who underwent microsurgical reconstruction of the thumb by great or second toe transfer. Forty-four patients were male and 10 were female. In 13 cases, the thumb was reconstructed by the Morrison wrap-around technique. In 27 cases, an extended variant of the Morrison technique was used in which the whole distal phalanx was harvested with skin and nail apparatus. Four patients were treated by great toe transfer and 10 were treated by second toe transfer. Follow-up ranged from 2 to 144 months. The group of patients treated by the wrap-around technique presented hallux rigidus in 38.5% of cases. The group of patients treated by the extended variant of the Morrison technique presented a lesser tendency to hallux rigidus but a clear reduction of the pushing phase of hallux. The group of patients treated by second toe transfer presented a third and fourth metatarsal bone overload that was confirmed by a statistical Wilcoxon test: overload was linked to a plantar hyperkeratosis at the third metatarsal (20%), fourth metatarsal (10%), or fifth metatarsal bone (20%). A claw deformity of the third and fourth toes was observed in 20% of these patients. The four patients who underwent microsurgical reconstruction of the thumb by great toe transfer exhibited an overload of central and lateral metatarsal bones. Second toe transfer is not associated with the functional or cosmetic changes seen in great toe transfer and is therefore preferred.(ABSTRACT TRUNCATED AT 250 WORDS)

The effects of scopolamine and cues to forget on pigeons' memory for time

Pigeons were trained with a 0-s delayed symbolic matching-to-sample procedure to indicate whether a houselight sample stimulus was short (2 s) or long (8 s) by pecking a red or a green comparison stimulus. In Experiment 1, the pigeons received injections of scopolamine hydrobromide (0.015 mg/kg), or saline, and the delay interval was manipulated (0, 1, 3, and 9 s). Memory for time was significantly poorer following scopolamine injections than following saline injections. A significant choose-short bias was observed under scopolamine at delays as brief as 3 s, but not under saline. In Experiment 2, a brief postsample cue (a vertical or horizontal line) signaled whether the comparison stimuli would be presented or omitted on each trial. During training, comparison stimuli were always presented following the remember (R) cue, but never following the forget (F) cue. During testing, memory for time was significantly poorer on F-cue trials than on R-cue trials. A significant choose-short bias was observed on F-cue trials at the 5- and 10-s delays, but not on R-cue trials. The results suggest that anticholinergic blockade accelerates the rate at which memory for temporal events is foreshortened in working memory. This effect is similar to that produced by an explicit cue to forget the temporal sample.