Interaction of ingested leucine with glycine on insulin and glucose concentrations.

The majority of individual amino acids increase insulin and attenuate the plasma glucose response when ingested with glucose. Objective. To determine whether ingestion of two amino acids simultaneously, with glucose, would result in an additive effect. Leucine (Leu) and glycine (Gly) were chosen because they were two of the most potent glucose-lowering amino acids when given individually. Materials and Methods. Nine subjects received test items on four separate days. The first was a water control, then 25 g glucose, or Leu + Gly (1 mmol/kg fat-free mass each) ±25 g glucose, in random order. Glucose, insulin, and glucagon were measured frequently for 2.5 hours. Net areas were calculated. Results. The glucose area response decreased by 66%. The insulin area response increased by 24% after ingestion of Leu + Gly + glucose compared to ingestion of glucose alone. The decrease in glucose response was not additive; the increase in insulin response was far less than additive when compared to previously published individual amino acid results. The glucagon concentration remained unchanged. Conclusion. There is an interaction between Leu and Gly that results in a markedly attenuated glucose response. This occurred with a very modest increase in insulin response. Changes in glucagon response could not explain the results. The mechanism is unknown.

Ingestion of leucine + phenylalanine with glucose produces an additive effect on serum insulin but less than additive effect on plasma glucose.

Most individual amino acids stimulate insulin secretion and attenuate the plasma glucose response when ingested with glucose. We determined whether ingestion of two amino acids simultaneously with glucose would result in an additive effect on the glucose area response compared with ingestion of amino acids individually. Leucine and phenylalanine were chosen because they were two of the most potent glucose-lowering amino acids when given individually. Eight healthy subjects were studied on four separate days. Test meals were given at 0800. The first meal was a water control. Subjects then received 25 g glucose or leucine + phenylalanine (1 mmol/kg fat free body mass each) ±25 g glucose in random order. Glucose, insulin and glucagon were measured frequently for 2.5 hours thereafter. Net areas under the curves were calculated using the mean fasting value as baseline. The insulin response to leucine + phenylalanine was additive. In contrast, the decrease in glucose response to leucine + phenylalanine + glucose was less than additive compared to the individual amino acids ingested with glucose. Interestingly, the insulin response to the combination was largely due to the leucine component, whereas the glucose response was largely due to the phenylalanine component. Glucose was unchanged when leucine or phenylalanine, alone or in combination, was ingested without glucose. This trial is registered with ClinicalTrials.gov NCT01471509.

Comparative reliability of the make and break tests for hip abduction assessment.

OBJECTIVE: To investigate the reliability of "make test" (MT) and "break test" (BT) of hip abduction using hand-held dynamometry. DESIGN: A repeated measures reliability assessment design for the estimation of inter-rater reliability, in which pairs of testers rated each subject in a 2/3 fractional factorial was used. Both tests ("BT" and "MT") were performed on both legs twice by 2 testers, for a total of 16 ratings for each participant. PARTICIPANTS: 39 healthy subjects between the ages of 21 and 70 years old volunteered. MAIN OUTCOME MEASURE: Variance components were computed from the repeated measures to assess inter-rater reliability of measurement. Reliability was estimated as a ratio of variance components. RESULTS: Both tests proved to be highly reliable in nature with values above 0.87 overall. Further examination revealed that gender had a small effect on reliability, yet differences in results were noted between raters on the BT more than the MT. CONCLUSIONS: Hip abduction strength can be measured and reproduced between testers reliably using both a "MT" and "BT" and a long lever arm with pelvic stabilization. Statistically, the "MT" appears to be slightly more reliable than the "BT", but clinically, the "BT" is more practical and convenient.

Serological response to Bartonella species in febrile patients from Nepal.

The Bartonella-associated illnesses are spread world-wide and involve a broad spectrum of signs and symptoms in humans. Several Bartonella species have been shown to be responsible for cases of febrile illnesses. Little information exists on distribution of Bartonella species and their role in human diseases in Nepal. Our preliminary study, a retrospective serological survey of archived specimens, suggests that Bartonella antibodies are prevalent among febrile patients in the Kathmandu Valley of Nepal.

Human seroreactivity against Bartonella species in the Democratic Republic of Congo.

OBJECTIVE: To assess the presence and identity of Bartonella species in a pool of human blood samples from DRC Congo. METHODS: Blood (±120µL) was collected anonymously from Congolese patients and placed on calibrated filter papers. Bartonella serology determination was performed using an indirect immunofluorescence assay (IFA) against six specific Bartonella antigens and Coxiella burnetii (C. burnetii) antigen. The end cut-off value for Bartonella sp. was a titre greater than 1:200. RESULTS: None of the patients was positive for Bartonella elizabethae, Bartonella vinsonii subsp. vinsonii or Bartonella vinsonii subsp. arupensis nor for C. burnetti, but 4.5% of the 155 samples were positive for either Bartonella henselae, Bartonella quintana, or Bartonella clarridgeiae. CONCLUSIONS: This preliminary study presents the first report of Bartonella species in the DR Congo and the first report of antibodies to Bartonella clarridgeiae in an African human population. Although few experimental trials have established the link between fleas and Bartonella transmission, the repeated detection of similar Bartonella species in fleas and humans in several countries suggests that Bartonellosis could be another flea-borne disease which specific reservoirs are still unknown.

Combining culture techniques for Bartonella: the best of both worlds.

In this study we compared some common Bartonella culturing methodologies using four diverse species causing human illnesses. Based on a review of the literature, we focused on three major inconsistencies between protocols: base medium, cell coculture, and temperature. Our data showed that Bartonella tamiae demonstrated temperature-dependent growth limitations between common culturing conditions only 2°C apart. Additionally, growth of B. quintana was significantly enhanced by the presence of mammalian cell coculture under mammalian cell culture conditions; however, when the medium was modified to incorporate insect cell culture-based medium, coculturing with mammalian cells was no longer needed. In this study, we were able to overcome these temperature- and cell-dependent limitations and accommodate all of the strains tested by combining mammalian cell culture-based medium with insect cell culture-based medium.

Acute arboviral infections in Guinea, West Africa, 2006.

Acute febrile illnesses comprise the majority of the human disease burden in sub-Saharan Africa. We hypothesized that arboviruses comprised a considerable proportion of undiagnosed febrile illnesses in Guinea and sought to determine the frequency of arboviral disease in two hospitals there. Using a standard case definition, 47 suspected cases were detected in approximately 4 months. Immunoglobulin M antibody capture enzyme-linked immunosorbent assays and plaque-reduction neutralization assays revealed that 63% (30/47) of patients were infected with arboviruses, including 11 West Nile, 2 yellow fever, 1 dengue, 8 chikungunya, and 5 Tahyna infections. Except for yellow fever, these are the first reported cases of human disease from these viruses in Guinea and the first reported cases of symptomatic Tahyna infection in Africa. These results strongly suggest that arboviruses circulate and are common causes of disease in Guinea. Improving surveillance and laboratory capacity for arbovirus diagnoses will be integral to understanding the burden posed by these agents in the region.

Optimal free thyroxine levels for thyroid hormone replacement in hypothyroidism.

OBJECTIVE: To determine whether a difference exists in the free thyroxine level required to achieve a normal thyrotropin (thyroid-stimulating hormone or TSH) level between patients with primary hypothyroidism and euthyroid control subjects and compare the free thyroxine levels in patients with primary and secondary hypothyroidism receiving thyroid hormone replacement. METHODS: We retrospectively assessed TSH and free thyroxine values in 58 patients with primary hypothyroidism and 78 euthyroid control subjects for whom screening thyroid function tests had been performed. From the medical records, we also obtained free thyroxine values for 23 patients with central hypothyroidism receiving stable levothyroxine replacement therapy. RESULTS: The mean free thyroxine level was significantly higher in patients with primary hypothyroidism than in euthyroid control subjects (1.36 +/- 0.201 ng/dL versus 1.10 +/- 0.155 ng/dL, respectively; P

Cyclooxygenase (COX)-1 and COX-2 participate in 5,6-epoxyeicosatrienoic acid-induced contraction of rabbit intralobar pulmonary arteries.

Epoxyeicosatrienoic acids (EETs) have been reported to contract intralobar pulmonary arteries (PA) of the rabbit in a cyclooxygenase (COX)-dependent manner. In the present study, we observed that COX-1 and COX-2 isoforms were expressed in freshly isolated PA of healthy rabbits. We examined the hypothesis that both COX isoforms participate in 5,6-EET-induced contraction of rabbit intralobar PA. Selective inhibition of COX-1 with 300 nM 5-(4-chlorophenyl)-1-(4-methoxyphenyl)-3-(trifluoromethyl)-1H-pyrazole (SC-560) prevented 5,6-EET (1x10(-8)-1x10(-5) M)-induced contractions of isolated intralobar rabbit PA rings in a manner similar to that observed with the nonselective cyclooxygenase inhibitor indomethacin at 10 microM. Selective inhibition of COX-2 with either 100 nM 5-bromo-2-(4-fluorophenyl)-3-(4-methylsulfonyl) thiophene (DUP-697) or 3 microM N-(2-cyclohexyloxy-4-nitrophenyl) methanesulfonamide (NS-398) shifted the EC50 value of 5,6-EET-induced PA contraction to the right but with considerably lower efficacy than SC-560. In rabbit PA, 5,6-EET-induced contraction was primarily dependent on COX-1 activity. Differential metabolism of 5,6-EET by COX-1 and COX-2 does not explain the primary dependence of PA contraction on COX-1 activity because 5,6-EET was metabolized similarly by both COX isoforms. COX-1 and -2 were expressed primarily in PA endothelium where COX-1 expression was dense and uniform, whereas COX-2 expression was sparse and nonuniform. 5,6-EET-induced PA contraction was endothelium-dependent. These results suggest that 5,6-EET-induced contraction is primarily dependent on COX-1 activity.