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1.
Aerosp Med Hum Perform ; 90(8): 735-737, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31331425

RESUMO

INTRODUCTION: Due to the risk of hypoglycemia-related incapacitation, diabetic pilots requiring insulin are assessed as unfit according to the International Civil Aviation Organization and most national authorities. Some authorities, such as those from Canada, the United Kingdom, and the United States, permit selected insulin-treated pilots (ITDM-pilots) to fly subject to a protocol requiring pre- and in-flight capillary glucose measurements to show safe levels (>100-<300 mg · dl-1). Critics of such permission question the practicability of these in-flight measurements and whether clinically desired glycemic targets can be achieved while keeping glucose levels in the safe range. Subcutaneous continuous glucose monitoring (CGM) has recently been approved by the FDA as a stand-alone method to provide accurate glucose levels and treatment decision guidance in patients. This commentary considers that use of CGM by ITDM pilots facilitates practicability and recording of in-flight glucose measurements and facilitates achievement of clinically desired glycemic targets without increasing hypoglycemia risks.Strollo F, Simons R, Mambro A, Strollo G, Gentile S. Continuous glucose monitoring for in-flight measurement of glucose levels of insulin-treated pilots. Aerosp Med Hum Perform. 2019; 90(8):735-737.


Assuntos
Medicina Aeroespacial/métodos , Glicemia/análise , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemia/prevenção & controle , Insulina/administração & dosagem , Medicina Aeroespacial/instrumentação , Diabetes Mellitus Tipo 2/sangue , Estudos de Viabilidade , Humanos , Hipoglicemia/sangue , Hipoglicemia/induzido quimicamente , Insulina/efeitos adversos , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , Pilotos
2.
Front Physiol ; 9: 1551, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30483144

RESUMO

Astronauts coming back from long-term space missions present with different health problems potentially affecting mission performance, involving all functional systems and organs and closely resembling those found in the elderly. This review points out the most recent advances in the literature in areas of expertise in which specific research groups were particularly creative, and as they relate to aging and to possible benefits on Earth for disabled people. The update of new findings and approaches in space research refers especially to neuro-immuno-endocrine-metabolic interactions, optic nerve edema, motion sickness and muscle-tendon-bone interplay and aims at providing the curious - and even possibly naïve young researchers - with a source of inspiration and of creative ideas for translational research.

3.
Ann N Y Acad Sci ; 1163: 221-32, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19456343

RESUMO

The complex control of food intake and energy metabolism in mammals relies on the ability of the brain to integrate multiple signals indicating the nutritional state and the energy level of the organism and to produce appropriate responses in terms of food intake, energy expenditure, and metabolic activity. Central regulation of feeding is organized as a long-loop mechanism involving humoral signals and afferent neuronal pathways to the brain, processing in hypothalamic neuronal circuits, and descending commands using vagal and spinal neurons. Sensor mechanisms or receptors sensitive to glucose and fatty acid metabolism, neuropeptide and cannabinoid receptors, as well as neurotransmitters and neuromodulators synthesized and secreted within the brain itself are all signals integrated in the hypothalamus, which therefore functions as an integrator of signals from central and peripheral structures. Homeostatic feedback mechanisms involving afferent neuroendocrine inputs from peripheral organs, like adipose tissue, gut, stomach, endocrine pancreas, adrenal, muscle, and liver, to hypothalamic sites thus contribute to the maintenance of normal feeding behavior and energy balance. In addition to transcriptional events, peripheral hormones may also alter firing and/or connection (synaptology) of hypothalamic neuronal networks in order to modulate food intake. Moreover, intracellular energy sensing and subsequent biochemical adaptations, including an increase in AMP-activated protein kinase activity, occur in hypothalamic neurons. Understanding the regulation of appetite is clearly a major research effort but also seems promising for the development of novel therapeutic strategies for obesity.


Assuntos
Mamíferos/fisiologia , Animais , Metabolismo Energético , Comportamento Alimentar , Humanos , Hipotálamo/metabolismo , Sinapses/metabolismo
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