Photobiomodulation Mitigates Diabetes-Induced Retinopathy by Direct and Indirect Mechanisms: Evidence from Intervention Studies in Pigmented Mice

Objective

Daily application of far-red light from the onset of diabetes mitigated diabetes-induced abnormalities in retinas of albino rats. Here, we test the hypothesis that photobiomodulation (PBM) is effective in diabetic, pigmented mice, even when delayed until weeks after onset of diabetes. Direct and indirect effects of PBM on the retina also were studied.

Methods

Diabetes was induced in C57Bl/6J mice using streptozotocin. Some diabetics were exposed to PBM therapy (4 min/day; 670 nm) daily. In one study, mice were diabetic for 4 weeks before initiation of PBM for an additional 10 weeks. Retinal oxidative stress, inflammation, and retinal function were measured. In some mice, heads were covered with a lead shield during PBM to prevent direct illumination of the eye, or animals were treated with an inhibitor of heme oxygenase-1. In a second study, PBM was initiated immediately after onset of diabetes, and administered daily for 2 months. These mice were examined using manganese-enhanced MRI to assess effects of PBM on transretinal calcium channel function in vivo.

Results

PBM intervention improved diabetes-induced changes in superoxide generation, leukostasis, expression of ICAM-1, and visual performance. PBM acted in part remotely from the retina because the beneficial effects were achieved even with the head shielded from the light therapy, and because leukocyte-mediated cytotoxicity of retinal endothelial cells was less in diabetics treated with PBM. SnPP+PBM significantly reduced iNOS expression compared to PBM alone, but significantly exacerbated leukostasis. In study 2, PBM largely mitigated diabetes-induced retinal calcium channel dysfunction in all retinal layers.

Conclusions

PBM induces retinal protection against abnormalities induced by diabetes in pigmented animals, and even as an intervention. Beneficial effects on the retina likely are mediated by both direct and indirect mechanisms. PBM is a novel non-pharmacologic treatment strategy to inhibit early changes of diabetic retinopathy.

Biomass selection for optimal anaerobic treatment of olive mill wastewater

This research was conducted to identify the most efficient biomass out of five different types of biomass sources for anaerobic treatment of Olive Mill Wastewater (OMW). This study was first focused on examining the selected biomass in anaerobic batch systems with sodium acetate solutions (control study). Then, the different types of biomass were tested with raw OMW (water-diluted) and with pretreated OMW by coagulation-flocculation using Poly Aluminum Chloride (PACl) combined with hydrated lime (Ca(OH)2). Two types of biomass from wastewater treatment systems of a citrus juice producing company "PriGat" and from a citric acid manufacturing factory "Gadot", were found to be the most efficient sources of microorganisms to anaerobically treat both sodium acetate solution and OMW. Both types of biomass were examined under different concentration ranges (1-40 g l(-1)) of OMW in order to detect the maximal COD tolerance for the microorganisms. The results show that 70-85% of COD removal was reached using Gadot biomass after 8-10 days when the initial concentration of OMW was up to 5 g l(-1), while a similar removal efficiency was achieved using OMW of initial COD concentration of 10 g l(-1) in 2-4 days of contact time with the PriGat biomass. The physico-chemical pretreatment of OMW was found to enhance the anaerobic activity for the treatment of OMW with initial concentration of 20 g l(-1) using PriGat biomass. This finding is attributed to reducing the concentrations of polyphenols and other toxicants originally present in OMW upon the applied pretreatment process.

Microfluidic device for circulating tumor cell sorting, characterization, and culture

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Background: Circulating tumor cell (CTC) analysis is a promising approach to further characterize the tumor biology and the metastatic process, but has immediate clinical applications such as early predictive markers of response to chemotherapy. However, the devices that are used currently for CTC detection have a poor sensitivity. Microfluidic techniques offer new exciting perspectives in the field of cell sorting for CTC analysis. Methods: We propose here a new microfluidic system and strategy allowing the sorting of cells, their study by confoncal fluorescent microscopy and/or their subsequent culture. The core of our system is a self-organized array of superparamagnetic particles in a microchannel, allowing for the formation of a perfectly periodic and robust array. The superparamagnetic particles are coated with specific antibodies against surface antigens, in order to capture cells according to specific biomarkers. This original cell-separation microchip was integrated into a fully automated platform combining state-of-the-art microfluidic technologies, microvalves and nanofluidic pneumatic pumps. Results: Using B and T lymphocytes mixtures as a model biological system, the capture yield was better than 90%, and the specificity better than 97%. Captured cells were fully viable and were cultured in situ in the magnetic array. In clinics, immunophenotyping of circulating malignant B cells was performed using fluorescent confocal microscopy, and was successfully compared to flow cytometry data for each sample. Results on breast cancer cells will be presented at the meeting. Conclusions: This new system is a promising approach for efficient CTC sorting, analysis and culture in a completely integrated manner.

No significant financial relationships to disclose.

The Role of the Endocrinologist in the Gender Adequacy Process and the Barriers for Adequate Transgender Health Care

The transgender universe comprises a wide range of individuals who do not identify with the gender role related to their birth sex, presenting distinct gender identities that transcend the binary concept of female and male. The follow-up of this population requires specific knowledge and training for its demands and peculiarities. Hormone therapy is a key point in the process of gender adequacy, and despite the increase in demand for specialized health services, there are still many barriers to full and free of prejudice health care. This is a descriptive and exploratory study about the characteristics of the professional training of the doctors involved in transgender health care, in particular the endocrinologist, and to enable an overview of the doctor-patient relationship and medical follow-up in the context of transsexuality in the Federal District. For this purpose, questionnaires were used for physicians: endocrinologists, family and community physicians, urologists, and psychiatrists; and transgender people residents of the Federal District. This study shows that most of the professionals involved in the process of gender adequacy, in particular the endocrinologist, do not present confidence or knowledge to accomplish it, and prejudice is still presented in a striking way in health care. In Federal District, services are not adequately structured for the care of this population, both from the perspective of doctors and transgender people. Moreover, in this sample, it was observed that the higher degree of specific knowledge in the subject increases the sensation of confidence of the professional to treat transgender people but does not correlate with the prejudice.

A Population Service Evaluation of the ADHD Pathway of Children and Young People's Services, Malta

Introduction

ADHD is the commonest neurodevelopmental disorder in young people (YP) aged 5–18 years. YP with untreated ADHD are 5 times more likely to develop co-morbid psychiatric disorders.

Objectives

To carry out a population service evaluation of the assessment process and management of YP with ADHD at Child and Young People's Service (CYPS), Malta age 0–16 years for 2014.

Aims

To describe the service input, assessment and treatment of YP attending CYPS and compare to ADHD NICE guidelines 2008.

Methods

All patients diagnosed with ADHD at CYPS throughout 2014 were included. The incidence of YP with ADHD on treatment age 3–16 years in Malta was calculated. Information was collected from; (i) retrospective case file review and (ii) methylphenidate and atomoxetine registry and compared with NICE guidelines.

Results

One hundred and thirty-six YP were diagnosed with ADHD. The minimum 12-month incidence of ADHD on treatment (3–16 years) in Malta was 553 per 100,000. Pre-diagnosis assessments were more frequently performed by other YP services (n = 97, 71.3%, P ≤ 0.01). A psychiatrist or paediatrician confirmed the diagnosis in 113 (83.1%). Sixty-two (45.3%) of YP were prescribed medication, 50 (36.8%) were referred for parental skills course and 55 (40.4%) psychotherapy. Mean waiting time for first appointment was 187.6 days (CI ± 26.9, 0–720), and first specialist review was 301.0 days (CI ± 34.4, 0–800) (1–3).

Conclusions

The incidence for YP (3–16 years) with ADHD on treatment was lower than the US. Since most pre-diagnostic assessments were carried out by other services, this raised the question about the reliability and validity. We recommend a diagnostic MDT meeting following the multimodal assessment to diagnose ADHD. Medication prescribing followed NICE overall, standardising non-pharmacological management is required.

Disclosure of interest

The authors have not supplied their declaration of competing interest.