The role of Neurochemicals, Stress Hormones and Immune System in the Positive Feedback Loops between Diabetes, Obesity and Depression.

Type 2 diabetes mellitus (T2DM) and depression are significant public health and socioeconomic issues. They commonly co-occur, with T2DM occurring in 11.3% of the US population, while depression has a prevalence of about 9%, with higher rates among youths. Approximately 31% of patients with T2DM suffer from depressive symptoms, with 11.4% having major depressive disorders, which is twice as high as the prevalence of depression in patients without T2DM. Additionally, over 80% of people with T2DM are overweight or obese. This review describes how T2DM and depression can enhance one another, using the same molecular pathways, by synergistically altering the brain's structure and function and reducing the reward obtained from eating. In this article, we reviewed the evidence that eating, especially high-caloric foods, stimulates the limbic system, initiating Reward Deficiency Syndrome. Analogous to other addictive behaviors, neurochemical changes in those with depression and/or T2DM are thought to cause individuals to increase their food intake to obtain the same reward leading to binge eating, weight gain and obesity. Treating the symptoms of T2DM, such as lowering HbA1c, without addressing the underlying pathways has little chance of eliminating the disease. Targeting the immune system, stress circuit, melatonin, and other alterations may be more effective.

Unhealthy Lifestyle and Gut Dysbiosis: A Better Understanding of the Effects of Poor Diet and Nicotine on the Intestinal Microbiome.

The study of the intestinal or gut microbiome is a newer field that is rapidly gaining attention. Bidirectional communication between gut microbes and the host can impact numerous biological systems regulating immunity and metabolism to either promote or negatively impact the host's health. Habitual routines, dietary choices, socioeconomic status, education, host genetics, medical care and environmental factors can all contribute to the composition of an individual's microbiome. A key environmental factor that may cause negative outcomes is the consumption of nicotine products. The effects of nicotine on the host can be exacerbated by poor dietary choices and together can impact the composition of the gut microbiota to promote the development of metabolic disease including non-alcoholic fatty liver disease. This review explores the contribution of nicotine, poor dietary choices and other unhealthy lifestyle factors to gut dysbiosis.

The Combination of High-Fat Diet and Oral Marijuana Promotes the Development of Fibrosis in the Mouse Corpora Cavernosa.

INTRODUCTION: The link between cannabis use and erectile dysfunction remains unclear. Moreover, the effect of cannabis in tandem with current Western dietary habits is an area in male sexual health that has yet to be explored. This study seeks to investigate the impact of diet and cannabis on penile health in an animal model. AIM: To determine the effects of diet and oral cannabis extract on fibrosis and oxidative stress within the corpora cavernosa of mice. METHODS: This is a pilot animal study in which groups of 2-month old C57BL/6J male mice were fed a normal chow diet (NCD) or high-fat diet (HFD) daily and treated with or without either MJ or THC extract for 2 months. After euthanization, mouse penises were isolated and processed for immunohistochemical studies to determine: (i) smooth muscle cell to collagen content, (ii) myofibroblast proliferation, and (iii) anti-oxidative activity. MAIN OUTCOME MEASURES: Quantitative assessment of immunohistochemical markers of fibrosis and oxidative stress within the corpora cavernosa of mice fed a high-fat diet in combination with either oral marijuana (MJ) or Δ-9-tetrahydrocannabinol extract (THC). RESULTS: The combination of HFD with MJ resulted in: (i) a decrease in the smooth/collagen ratio in the corpora cavernosa, (ii) an increase in alpha-smooth muscle actin expression in the tunica albuginea compatible with myofibroblast proliferation, and (iii) a decrease in heme oxygenase 1 expression indicating an increase in oxidative stress. Significant histological changes were not observed in the HFD + THC group. CONCLUSIONS: HFD combined with oral MJ extract led to structural alterations in erectile tissue that are associated with accelerated corporal fibrosis. However, the addition of THC to the diet did not exacerbate histological changes within the corpora. Further studies are warranted to elucidate the discrepant effects between MJ and THC in order to optimize the therapeutic potential of cannabis and minimize its adverse effects on penile health. S Nguyen, M Mangubat, S Eleswarapu, et al. The Combination of High-Fat Diet and Oral Marijuana Promotes the Development of Fibrosis in the Mouse Corpora Cavernosa. Sex Med 2021;9:100312.

High Prevalence of Adrenal Remnant Tissue in Patients Undergoing Bilateral Adrenalectomy for Cushing's Disease.

Bilateral adrenalectomy (BLA) is a treatment option for patients with Cushing's Disease (CD) if transsphenoidal pituitary surgery fails or is not a therapeutic option. For most patients, BLA eliminates endogenous glucocorticoid and mineralocorticoid production, but for a small number of patients, endogenous secretion of adrenal hormones from adrenal tissue continues or recurs, leading to signs and symptoms of hypercortisolism. If adrenal tissue is confined to the adrenal bed, it is considered adrenal remnant tissue, while if it is outside the adrenal bed, it is considered adrenal rest tissue. We retrospectively evaluated morning serum cortisol, nighttime serum cortisol, nighttime salivary cortisol, and 24-h urine free cortisol on at least three occasions in 10 patients suspected of having endogenous cortisol production. Imaging of adrenal remnant tissue was also reviewed. Ten of 51 patients who underwent BLA during this time period had adrenal remnant/rest tissue marked by detectable endogenous glucocorticoid production; 9 of the 10 patients had signs and symptoms of hypercortisolism. Localization and treatment proved difficult. We conclude that the incidence of adrenal remnant/rest tissue in those undergoing BLA following unsuccessful pituitary surgery was 12% although there may have been a selection bias affecting this prevalence. The first indication of remnant tissue occurrence is a reduction in glucocorticoid replacement with symptoms of hypercortisolism. If this occurs, endogenous cortisol production should be tested for by cortisol measurements using a highly specific cortisol assay while the patient is taking dexamethasone or no glucocorticoid replacement. Endocrinologists need to monitor the development of both adrenal remnant tissue and Nelson's syndrome following BLA.

A mouse model for chronic intermittent electronic cigarette exposure exhibits nicotine pharmacokinetics resembling human vapers.

Electronic cigarettes (E-cig) use is increasing rapidly, particularly among youths. Animal models for E-cig exposure with pharmacokinetics resembling human E-cig users are lacking. We developed an E-cig aerosol exposure system for rodents and a chronic intermittent delivery method that simulates E-cig users who vape episodically during wakefulness and abstain during sleep. Mice were exposed to E-cig in a programmed schedule at very low, low, medium, or high doses defined by duration of each puff, number of puffs per delivery episode and frequency of episodes in the dark phase of a 12/12-h circadian cycle for 9 consecutive days. The plasma nicotine/cotinine levels and their time courses were determined using LC/MS-MS. We assessed the body weight, food intake and locomotor activity of Apolipoprotein E null (ApoE-/-) mice exposed to chronic intermittent E-cig aerosol. Plasma nicotine and cotinine levels were positively correlated with exposure doses. Nicotine and cotinine levels showed a circadian variation as they increased with time up to the maximum nicotine level of 21.8 ±â€¯7.1 ng/mL during the daily intermittent E-cig exposure in the 12-h dark phase and then declined during the light phase when there was no E-cig delivery. Chronic E-cig exposure to ApoE-/- mice decreased body weight, food intake and increased locomotion. Our rodent E-cig exposure system and chronic intermittent exposure method yield clinically relevant nicotine pharmacokinetics associated with behavioral and metabolic changes. The methodologies are essential tools for in vivo studies of the health impacts of E-cig exposure on CNS, cardiovascular, pulmonary, hepatic systems, metabolism and carcinogenesis.

Patterns of physiological decline due to age and selection in Drosophila melanogaster.

In outbred sexually reproducing populations, age-specific mortality rates reach a plateau in late life following the exponential increase in mortality rates that marks aging. Little is known about what happens to physiology when cohorts transition from aging to late life. We measured age-specific values for starvation resistance, desiccation resistance, time-in-motion, and geotaxis in ten Drosophila melanogaster populations: five populations selected for rapid development and five control populations. Adulthood was divided into two stages, the aging phase and the late-life phase according to demographic data. Consistent with previous studies, we found that populations selected for rapid development entered the late-life phase at an earlier age than the controls. Age-specific rates of change for all physiological phenotypes showed differences between the aging phase and the late-life phase. This result suggests that late life is physiologically distinct from aging. The ages of transitions in physiological characteristics from aging to late life statistically match the age at which the demographic transition from aging to late life occurs, in all cases but one. These experimental results support evolutionary theories of late life that depend on patterns of decline and stabilization in the forces of natural selection.

Juxta-articular Myxoma of the Temporomandibular Joint.

The juxta-articular myxoma represents a benign mesenchymal neoplasm that arises from tissue within or adjacent to a joint space. There have been a number of reported cases involving myxomas of the knee, shoulder, elbow, wrist, and hip. To our knowledge there, however, have been no reported cases of juxta-articular myxomas of the temporomandibular joint (TMJ). This report describes the case of a 57-year-old woman with a juxta-articular myxoma of the left TMJ extending into the infratemporal fossa (ITF). Access to the tumor was accomplished via a preauricular incision and low condylar osteotomy which allowed for displacement of the condyle for direct visualization and excision of the tumor. The postoperative course was benign and the patient demonstrated no cosmetic or functional limitation. Likewise, follow-up at 30 months showed no evidence of recurrence. Benign encapsulated tumors of the ITF can be effectively accessed by means of a modified preauricular incision, low condylar osteotomy, and anterior meniscal release. This direct approach allows for excellent surgical exposure, minimal surgical site morbidity, and maintenance of physiologic joint function and occlusion.

Modified temporomandibular joint disc repositioning with miniscrew anchor: part I--surgical technique.

Anterior disc displacement is one of the most common conditions affecting the temporomandibular joint. In the authors' previous publications, they reported on the basic technical elements of disc repositioning surgery. However, the present article presents some critical modifications that have allowed the safe and successful performance of this procedure during the past 3 years.

Use of computer-assisted templates for placement of osteotomies in lateral gap arthroplasty.

PURPOSE: To evaluate the effectiveness of computer-generated surgical templates for precise bone removal in the treatment of temporomandibular joint (TMJ) ankylosis with a medially displaced condyle. MATERIALS AND METHODS: Patients found to have a medially displaced condylar head and lateral bony fusion from January 2012 through January 2014 were included in the study. ProPlan CMF 1.4 software (Materialise Medical, Leuven, Belgium) was used to design the osteotomies for the lateral bony fusion and protect the medial condylar head. Surgical templates were fabricated to transfer the design to the operation and effectiveness was evaluated postoperatively using computed tomographic (CT) scan comparisons. RESULTS: In 5 surgeries with a total of 7 joints, the surgical templates fit well and accurately guided the osteotomies. The skull base, external auditory canal, major vessels, and residual condyle were well protected. Postoperative CT difference analysis calculated an average difference of 1.044 mm. CONCLUSIONS: Computer-assisted surgical templates accurately guided bone removal and protected the residual condylar head, skull base, and external auditory canal in the treatment of TMJ ankylosis.

Application of digital templates to guide total alloplastic joint replacement surgery with biomet standard replacement system.

PURPOSE: To design and manufacture digital templates to guide Biomet total alloplastic joint replacement surgery (Biomet, Warsaw, IN) and evaluate the clinical efficacy. MATERIALS AND METHODS: Six patients who underwent total alloplastic joint replacement surgery from November 2013 to March 2014 were included in this study. Before surgery, the Biomet standard prostheses were scanned and imported into the ProPlan CMF 1.4 software (Materialise NV, Leuven, Belgium) for virtual positioning and osteotomy planning. Digital templates were then designed to guide intraoperative bone trimming and prosthesis placement. A postoperative computed tomography scan was taken and used to measure how well the postsurgical images corresponded to the images generated in the preoperative plan. RESULTS: The digital templates were smoothly positioned and easily adapted, and they accurately guided bone trimming and prosthesis implantation. In addition, vital anatomic structures such as the skull base and inferior alveolar neurovascular bundle were not injured during the procedures. The result of the merged postoperative and preoperative computed tomography scans showed that the position of the prostheses corresponded quite accurately to the preoperative design, with an error of 1.139±0.183 mm. CONCLUSIONS: Digital templates can accurately guide the bone trimming required for placement of Biomet total alloplastic joints. Likewise, these templates help place the prostheses in the desired locations, enhance stability, and avoid damage to the skull base and inferior alveolar neurovascular bundle.

Improving health services for residents through community-based participatory research: a public housing leadership perspective.

BACKGROUND: In response to feedback from a health forum, resident leaders of public housing in Washington, DC, were inspired to create a health survey for and by the residents. OBJECTIVE: The survey was designed to document residents' concerns about health, health care, and environmental threats. It also explored tobacco use and support for smoke-free housing. METHODS: A newly created Health Planning Committee of the Citywide Advisory Board, including residents, academics, and representatives of health and housing organizations, facilitated the creation of a health needs assessment. Questionnaires were initially mailed, then hand-delivered to every public housing household. More than 1,000 completed questionnaires have now been returned. LESSONS LEARNED: This project highlights a model that places resident leaders in charge of health issues, including leading advocacy efforts for policies to reduce health disparities in public housing. It identifies research challenges and ways to overcome them and empowers the community for continued research.

Optimal foraging: The responses of Peromyscus leucopus to experimental changes in processing time and hunger.

Food density, degree of hunger prior to foraging, and food processing difficulty were varied in order to determine their effects on the diet diversity of captive Peromyscus leucopus foraging for buried seeds. No relationship was found between diet diversity and food density. However, diet diversity exhibited a significantly positive relationship with hunger, and a significantly negative relationship with seed processing time. These results strongly support optimal foraging theory.