How should we differentiate hypoglycaemia in non-diabetic patients?

Hypoglycaemic syndromes are rare in apparently healthy individuals and their diagnosis can be a difficult challenge for clinicians as there are no shared guidelines that suggest how to approach patients with a suspect hypoglycaemic disorder. Since hypoglycaemia symptoms are common and nonspecific, it's necessary to document the Whipple Triad (signs and/or symptoms compatible with hypoglycaemia; relief of symptoms following glucose administration; low plasma glucose levels) before starting any procedure. Once the triad is documented, a meticulous anamnesis and laboratory tests (blood glucose, insulin, proinsulin, C-peptide, ß-hydroxybutyrate and anti-insulin antibodies) should be performed. Results can guide the physician towards further specific tests, concerning the suspected disease. In this review, we consider all current causes of hypoglycaemia, including rare diseases such as nesidioblastosis and Hirata's syndrome, describe appropriate tests for diagnosis and suggest strategies to differentiate hypoglycaemia aetiology.

Magnetic Analysis of MgFe Hydrotalcites as Powder and Dispersed in Thin Films within a Keratin Matrix.

Hydrotalcites (HTlcs) are a class of nanostructured layered materials that may be employed in a variety of applications, from green to bio technologies. In this paper, we report an investigation on HTlcs made of Mg and Fe, recently employed to improve the growth in vitro of osteoblasts within a keratin sponge. We carried out an analysis of powder materials and of HTlcs dispersed in keratin and spin-coated on a Si/SiO2 substrate at different temperatures. A magnetic study of the powders was carried out with a Quantum Design Physical Property Measurement System equipped with a Vibrating Sample Magnetometer. The data gathered prove that these HTlcs are fully paramagnetic, and keratin showed a very small magnetic response. Optical and Atomic Force Microscopy analyses of the thin films provide a detailed picture of clusters randomly dispersed in the films with various dimensions. The magnetic properties of these films were characterized using the Nano Magneto Optical Kerr Effect (NanoMOKE) down to 7.5 K. The data collected show that the local magnetic properties can be mapped with a micrometric resolution distinguishing HTlc regions from keratin ones. This approach opens new perspectives in the characterization of these composite materials.

The Effect of a DC Magnetic Field on the AC Magnetic Properties of Oleic Acid-Coated Fe3O4 Nanoparticles.

The AC magnetic properties of a sample of Fe3O4 nanoparticles coated with oleic acid have been investigated with the help of AC susceptibility measurements. In particular, several DC magnetic fields have been superimposed on the AC field, and their effect on the magnetic response of the sample has been analysed. The results show the presence of a double peak structure in the imaginary component of the complex AC susceptibility measured as a function of the temperature. A preliminary evaluation of the Mydosh parameter for both peaks gives the information that each one of them is associated with a different state of interaction between nanoparticles. The two peaks evolve both in amplitude and position when the intensity of the DC field is changed. The field dependence of the peak position shows two different trends, and it is possible to study them in the framework of the currently existing theoretical models. In particular, a model of non-interacting magnetic nanoparticles has been used to describe the behaviour of the peak at lower temperatures, whereas the behaviour of the peak at higher temperatures has been analysed in the framework of a spin-glass-like model. The proposed analysis technique can be useful for the characterisation of magnetic nanoparticles used in several types of applications, such as biomedical and magnetic fluids.

How to Treat Right Heart Failure. Tips for Clinicians in Everyday Practice.

In recent years, several observations reported that intolerance of physical exertion and other cardinal symptoms in heart failure (HF) are closely related to the functionality of the right ventricular (RV), regardless of left heart. It has been demonstrated that the RV dysfunction complicates the course, aggravates the quality of life, and increases the mortality of HF patients. The present review is aimed to report tips physicians about the current therapeutic management of right HF during acute stage and chronic phase, shedding light on the RV and its failure and providing physicians with essential information for everyday clinical practice.

The complex relationship between physical activity and diabetes: an overview.

Diabetes mellitus (DM) is a widespread condition, representing a challenging disease to manage. Exercise is being increasingly recommended as part of the therapeutic regimen for DM but the management of different forms of physical activity is difficult for individuals with diabetes, trainers, and physicians. Regular exercise can improve health and well-being, helping individuals to achieve their target lipid profile, body composition, cardio-respiratory fitness, and glycemic goals. People with diabetes tend to be as inactive as the general population, with a large percentage of individuals not achieving the minimum amount of recommended physical activity levels. Indeed, several barriers to exercise exist for persons with diabetes, including sports eligibility, multi-modality management of diabetic athletes, and inadequate knowledge about adequate type and intensity of exercise. The aim of the present review is to provide the current understanding of mechanisms, recommendations, and beneficial effects of different modalities of exercise for the treatment of DM.