DIABSAT Telemedicine Itinerant Screening of Chronic Complications of Diabetes Using a Satellite.

BACKGROUND: Health authorities recommend regular screening for the chronic complications of diabetes. The ENTRED * survey results show that insufficient screening is undertaken. The DIABSAT † program aims to improve care for diabetes patients in rural areas of the Midi-Pyrénées region, telemonitoring complications of diabetes through an itinerant screening service. METHODS: A vehicle was equipped with a satellite dish and medical equipment for screening ophthalmological, renal, vascular, and neuropathic damage and assessing the level of risk of diabetic foot ulceration. Onboard, a nurse performs some or all of the tests on patients who have had no diabetes review for over a year. The data are entered into a computer and transmitted by satellite for interpretation by designated specialists. The results are sent to patients, general practitioners (GPs), and diabetologists. RESULTS: Two hundred twenty-eight screening days were held in six departments of the Midi-Pyrénées between 2010 and 2013. 1,545 patients were screened: mean age 70.7 years, 55.8% men. 93.4% diagnosed with type 2 diabetes, mean duration 11.7 years. Recruitment was chiefly by health professionals (55%). 17-32% of tests detected pathologies: 18.7% diabetic retinopathy, 31.9% microalbuminuria, 17.2% lower limb arteriopathy, 28.3% peripheral neuropathy, and 28.2% high risk of foot ulceration (grade 2: 20.6% and grade 3: 7.6%). CONCLUSION: The large number of patients screened and the high rate of pathological results found, confirm telemonitoring viability and relevance. DIABSAT, a primary resource for healthcare professionals, improves healthcare access through its innovative organization and use of satellite technology.

Regional brain variations of cytochrome oxidase staining during olfactory learning in the honeybee (Apis mellifera).

Regional brain variations of cytochrome oxidase (CO) staining were analyzed in the honeybee (Apis mellifera) after olfactory conditioning of the proboscis extension reflex. Identification of brain sites where stimuli converge was done by precise image analysis performed in antennal lobes (AL) and mushroom bodies (MB). In Experiment 1, bees received 5 odorant stimulations that induced a transient decrease of CO activity in the lateral part of the AL. In Experiment 2, bees were trained with 5-trial olfactory conditioning. CO activity transiently increased in the lips of the MB calyces. There was also a delayed increase in the lateral part of the AL. An olfactory stimulus presented alone and an odor paired to a sucrose stimulation are treated by different pathways, including both AL and MB.

The insecticide imidacloprid is a partial agonist of the nicotinic receptor of honeybee Kenyon cells.

The main targets of the insecticide imidacloprid are neuronal nicotinic acetylcholine receptors (nAChRs) within the insect brain. We tested the effects of imidacloprid on ligand-gated ion channels of cultured Kenyon cells of the honeybee, Apis mellifera. Kenyon cells build up the mushroom body neuropils, which are involved in higher order neuronal processes such as olfactory learning. We measured whole-cell currents through nicotinic and gamma-aminobutyric acid (GABA) receptors using patch-clamp techniques. Pressure applications of imidacloprid elicited inward currents, which were irreversibly blocked by alpha-bungarotoxin. Imidacloprid was a partial nicotinic agonist, since it elicited only 36% of ACh-induced currents and competitively blocked 64% of the peak ACh-induced currents. GABA-induced currents were partially blocked when imidacloprid was coapplied and this block was independent upon activation of nAChRs. Our results identify the honeybee nAChR as a target of imidacloprid and an imidacloprid-induced inhibition of the insect GABA receptor.

Metabotropic glutamate receptor subtype 1 regulates sodium currents in rat neocortical pyramidal neurons.

Brain sodium channels (NaChs) are regulated by various neurotransmitters such as acetylcholine, serotonin and dopamine. However, it is not known whether NaCh activity is regulated by glutamate, the principal brain neurotransmitter. We show here that activation of metabotropic glutamate receptor (mGluR) subtype 1 regulates fast transient (I(NaT)) and persistent Na(+) currents (I(NaP)) in cortical pyramidal neurons. A selective agonist of group I mGluR, (S)-3,5-dihydroxyphenylglycine (DHPG), reduced action potential amplitude and decreased I(NaT). This reduction was blocked when DHPG was applied in the presence of selective mGluR1 antagonists. The DHPG-induced reduction of the current was accompanied by a shift of both the inactivation curve of I(NaT) and the activation curve of I(NaP). These effects were dependent on the activation of PKC. The respective role of these two regulatory processes on neuronal excitability was determined by simulating transient and persistent Na(+) conductances (G(NaT) and G(NaP)) with fast dynamic-clamp techniques. The facilitated activation of G(NaP) increased excitability near the threshold, but, when combined with the down-regulation of G(NaT), repetitive firing was strongly decreased. Consistent with this finding, the mGluR1 antagonist LY367385 increased neuronal excitability when glutamatergic synaptic activity was stimulated with high external K(+). We conclude that mGluR1-dependent regulation of Na(+) current depresses neuronal excitability, which thus might constitute a novel mechanism of homeostatic regulation acting during intense glutamatergic synaptic activity.

Involvement of alpha-bungarotoxin-sensitive nicotinic receptors in long-term memory formation in the honeybee (Apis mellifera).

In the honeybee Apis mellifera, multiple-trial olfactory conditioning of the proboscis extension response specifically leads to long-term memory (LTM) which can be retrieved more than 24 h after learning. We studied the involvement of nicotinic acetylcholine receptors in the establishment of LTM by injecting the nicotinic antagonists mecamylamine (1 mM), alpha-bungarotoxin (alpha-BGT, 0.1 mM) or methyllycaconitine (MLA, 0.1 mM) into the brain through the median ocellus 20 min before or 20 min after multiple-trial learning. The retention tests were performed 1, 3, and 24 h after learning. Pre-training injections of mecamylamine induced a lower performance during conditioning but had no effect on LTM formation. Post-training injections of mecamylamine did not affect honeybees' performances. Pre-training injections of MLA or post-training injection of alpha-BGT specifically induced LTM impairment whereas acquisition as well as memory retrieval tested 1 or 3 h after learning was normal. This indicates that brain injections of alpha-BGT and MLA did not interfere with learning or medium-term memory. Rather, these blockers affect the LTM. To explain these results, we advance the hypothesis that honeybee alpha-BGT-sensitive acetylcholine receptors are also sensitive to MLA. These receptors could be essential for triggering intracellular mechanisms involved in LTM. By contrast, medium-term memory is not dependent upon these receptors but is affected by mecamylamine.