Methanolic extract of Moringa oleifera leaves improves glucose tolerance, glycogen synthesis and lipid metabolism in alloxan-induced diabetic rats.

BACKGROUND: Glucose-lowering effects of Moringa oleifera extracts have been reported. However, the mechanism for its hypoglycemic effects is not yet understood. This study investigated the effect of oral administration of methanolic extracts of M. oleifera (MOLE) on glucose tolerance, glycogen synthesis, and lipid metabolism in rats with alloxan-induced diabetes. METHODS: MOLE was screened for key phytochemicals and its total flavonoids and phenolic contents were quantified. Diabetes was induced by intraperitoneal injection of 120 mg/kg BW alloxan. Normal and diabetic control rats received saline, while rats in other groups received 300 or 600 mg/kg body weight of MOLE or metformin (100 mg/kg body weight of metformin) for 6 weeks. Food intake and body weight were monitored throughout the experiment. Intraperitoneal glucose tolerance was assessed and serum glucose, insulin, and lipids were measured at the end of the experiment. Liver and muscle glycogen synthase activities, glycogen content, and glucose uptake were determined. RESULTS: Administration of MOLE did not affect food intake but inhibited weight loss, significantly (p<0.01) improved glucose tolerance, and increased serum insulin levels by 1.3-1.7-fold (p<0.01). MOLE treatment significantly (p<0.001) reduced serum concentrations of triglyceride, total cholesterol, and low-density lipoprotein (LDL)-cholesterol and enhanced serum level of high-density lipoprotein (HDL) by 2.4- to 3.2-fold (p<0.001). Glycogen synthase activities and glycogen contents were higher in MOLE-treated rats compared with rats receiving metformin or saline and the extract improved glucose uptake by 49%-59% (p<0.01). CONCLUSIONS: These results showed that hypoglycemic effects of MOLE might be mediated through the stimulation of insulin release leading to enhanced glucose uptake and glycogen synthesis.

SIRT2: tumour suppressor or tumour promoter in operable breast cancer?

PURPOSE: Sirtuins comprise a family of genes involved in cellular stress, survival and damage responses. They have been implicated in a range of diseases including cancer, with most information pertaining to their function in tumourigenesis being derived from in vitro studies, or model organisms. Their putative roles as tumour suppressors or tumour promoters remain to be validated in vivo. Little is known about their role in breast tumourigenesis. We sought to evaluate the seven sirtuin family members (SIRT1-7) in a human breast cancer cohort, in relation to clinico-pathological features and outcome of the disease. MATERIALS AND METHODS: Immunohistochemical analysis of SIRT1-7 protein levels was undertaken in 392 oestrogen receptor (ER+ve) and 153 ER-ve breast tumour samples. SIRT1-7 transcriptional levels were assessed in normal (n=25), non-malignant (n=73) and malignant (n=70) breast tissue using Relative Quantitative Real Time PCR. Statistical analyses determined if SIRT1-7 transcription or protein expression was associated with clinical parameters or outcome. RESULTS: In ER-ve tumours, high protein levels of nuclear SIRT2 were associated with reduced time to recurrence and disease-specific death. This association was only observed in Grade 3 tumours. In the ER+ve cohort, high SIRT2 nuclear levels were associated with shorter disease-free survival and time to recurrence whilst on Tamoxifen, in patients with Grade 3 tumours. Conversely, in Grade 2 tumours, high SIRT2 levels were associated with increased time to recurrence. CONCLUSIONS: Our data suggest that SIRT2 is the sirtuin predominantly involved in breast tumourigenesis and prognosis. It indicates that SIRT2 acts as a tumour suppressor or tumour promoter dependent upon breast tumour grade.

Guideline for prophylactic feeding tube insertion in patients undergoing resection of head and neck cancers.

BACKGROUND: Supplementary nutrition is an important aspect of the multidisciplinary management of head and neck cancer patients. In our unit, method of feeding is based on an arbitrary predicted duration of overall treatment (<30 days indicates NG feeding, >30 days prophylactic PEG tube insertion is appropriate). This paper provides a guideline to assist in choosing the feeding method early on to avoid the need for later PEG insertion in those who were initially fed orally or via NG tube. PATIENTS AND METHODS: 59 patients undergoing resection of head and neck tumours were included, grouped according to their tumour stage and location. They were assessed pre- and post-operatively for 5 years and their diet consistency score, method of supplementary feeding and weight were noted. RESULTS: Mean prophylactic PEG feeding duration was 771 days (N = 12), these patients mostly had T3/T4 tumours involving the tongue. Mean NG duration was 30.5 days (N = 42), 15 later had PEG insertion at mean 47 days post-operatively, resulting in a total mean supplementary feeding duration of 579.6 days. These patients tended to have higher stage tumours and poorer pre-operative diet consistency scores. 43 patients required post-operative radiotherapy. This significantly increased feeding duration versus surgery alone, and therefore increases the likelihood of requiring PEG insertion. CONCLUSIONS: Based on our findings, we have constructed an algorithm to assist in determining which patients with operable head and neck cancer should have prophylactic PEG tube insertion.

Takayasu's Arteritis: an important cause of stroke in younger patients.

Stroke in young patients is important and early diagnosis of Takayasu's Arteritis as the cause will assist in acute management. A retrospective notes review of six patients presenting with acute neurological symptoms secondary to TA was performed. Three male and three female patients (mean age of 32.2 years) were identified. Neurological presentations included four ischaemic strokes, one TIA, and one syncopal episode. Pulse loss, bruit, or a difference in brachial blood pressures was evident in five patients at presentation. 4 patients had a previous history of TIA, 3 had prior ischaemic limb symptoms and 1 had prodromal symptoms. A history of limb ischaemia, prodromal symptoms, absent pulses and asymmetric blood pressure should alert the clinician to possible TA.

Accessibility and quality of secondary care rheumatology services for people with inflammatory arthritis: a regional survey.

Secondary care rheumatology services for patients with inflammatory arthritis (IA) in the West Midlands were audited using Arthritis and Musculoskeletal Alliance (ARMA) standards of care. Questionnaires were analysed from 1,715 patients in 11 rheumatology departments. ARMA standards recommend full multidisciplinary team assessment; referral rates to nurse specialists (52.3%), physiotherapists (48.7%) and occupational therapists (36.5%) were, however, lower than expected. Attendance at existing hospital-led education groups was rare (8.9%), awareness of existing helplines was moderate (59.2%) but the proportion of patients reporting satisfaction with advice about their disease was high (80.5%). Significant variations were found between departments. For patients with IA < 2 years (n = 236), 84.5% were seen by a rheumatologist within the ARMA standard of 12 weeks of referral; diagnosis of a type of IA was made at the first rheumatology appointment in 66.4%; 82.8% of rheumatoid arthritis patients had commenced disease-modifying drugs, although time to commencement varied across departments. This study raises issues regarding provision of rheumatology services, prioritisation of patient referral and patient education.

Cardiovascular risk and COX-2 inhibition in rheumatological practice.

The use of specific COX-2 inhibitors in place of standard nonsteroidals for the treatment of arthritis appears to reduce the risk of serious gastrointestinal toxicity in this group of patients. However, the role played by these inhibitors in the generation or exacerbation of ischaemic cardiovascular disease is less clear. Clinical studies demonstrate that hypertension can be induced or aggravated by COX-2 inhibitors to a degree similar to that which occurs with standard nonsteroidals. Endothelial dysfunction, an indicator of cardiac ischaemia, may also be exacerbated by specific COX-2 inhibition and there is much debate as to whether these changes lead to an absolute increase in ischaemic cardiac events. These effects on cardiovascular risk factors appear all the more important in patients with rheumatoid arthritis where there is an increase in the incidence of ischaemic heart disease. Here we review the available data on COX-2 inhibition and cardiovascular disease and conclude that all patients who started these agents should have a careful assessment and modification of any cardiovascular risk factors.

Alcohol use and workplace aggression: an examination of perpetration and victimization.

PURPOSE: The purpose of the present investigation was to examine the relationship between victimization from and perpetration of workplace aggression between coworkers and frequency of alcohol use during the last year. METHODS: Civilian employees (N = 300) selected from the US population were interviewed over the telephone with psychometrically sound measures of workplace aggression and alcohol use frequency during the last year. Hierarchical regression analyses were used to examine the relationship between alcohol use and workplace aggression, after controlling for sociodemographic variables. RESULTS: Both percentage of days of any drinking and percentage of days of heavy drinking during the last year were positively related to (a) victimization from verbal and physical aggression at work and (b) perpetration of verbal and physical aggression at work. IMPLICATIONS: Consistent with research studies spanning the sociobehavioral literature, the present investigation found alcohol use was associated with perpetration of and victimization from verbal and physical workplace aggression. Although the study established an association exists between alcohol use and workplace aggression, future investigations should attempt to understand employee alcohol use in the context of a multifaceted model that includes other likely factors that contribute to the incidence of aggressive behavior on the job.

Means to the goal of remembering: developmental changes in awareness of strategy use--performance relations.

We examined awareness of the causal relation between strategy use and recall performance among preschoolers, first graders, and third graders, and the relation of this awareness to children's study behavior and recall. In session 1, children were presented with two study-recall trials; the second trial included questions concerning the child's study behavior. During Session 2, children viewed videotapes in which a model's strategy use (labeling versus no labeling) and recall level (high versus low) were varied orthogonally. Children judged whether the model tried to remember, rated how hard the model tried to remember, and described how they knew. Children who gave mentalistic explanations for their study behaviors in Session 1 recalled more than those giving nonmentalistic explanations. In Session 2, age-related differences were observed in awareness of the relation between strategy use and performance level. Further, children who demonstrated understanding of strategy use-performance relations in Session 2 were more likely to give mentalistic explanations for their own study behaviors in Session 1. The results further delineate the metamemorial development that contributes to effective strategy utilization.

Social sensitivity in adolescents and adults with learning disabilities.

This study investigated social sensitivity and self-concept in students with learning disabilities (LD) and their non-learning-disabled (non-LD) peers. Thirty students each from public junior and senior high schools and a community college participated in the study; at each grade level, half were identified as learning disabled and half experienced no learning problem. Students were individually assessed in 30-minute interviews for their accuracy in interpreting the thoughts and feelings of actors in tape-recorded stories depicting two adults in happy angry, anxious, and sad interactions. A questionnaire assessing four dimensions of self-concept in learning situations (motivation, task orientation, problem-solving ability, and class membership) was also administered. LD students at all grade levels were significantly less accurate at interpreting social situations than were their non-LD peers, and had significantly lower self-concepts. These results support the need for remediation efforts specifically aimed at social skills for overcoming social deficits in adulthood.

Liquid chromatography in pharmaceutical analysis IV: determination of antispasmodic mixtures.

Parameters associated with the separation of antianxiety-antispasmodic agents were investigated using high-pressure liquid chromatography. Eight widely prescribed drugs were studied. The compounds were chromatographed on reversed-phase octadecyltrichlorosilane (C18) or diphenyldichlorosilane (phenyl) columns, using mixtures of absolute methanol and distilled water buffered with ammonium dihydrogen phosphate, ammonium acid phosphate, or ammonium carbonate. A mixture of phenobarbital-propantheline bromide was selected to demonstrate the utility of the separation and quantification method. The mixture was chromatographed on a phenyl column, using absolute methanol-aqueous 1 percent ammonium dihydrogen phosphate (60:40) (pH 5.85) at a flow rate of 1.4 ml/min. Each determination can be achieved in approximately 15 min with an accuracy of 1-2 percent.