Point-of-care breath sample analysis by semiconductor-based E-Nose technology discriminates non-infected subjects from SARS-CoV-2 pneumonia patients: a multi-analyst experiment.

Metal oxide sensor-based electronic nose (E-Nose) technology provides an easy to use method for breath analysis by detection of volatile organic compound (VOC)-induced changes of electrical conductivity. Resulting signal patterns are then analyzed by machine learning (ML) algorithms. This study aimed to establish breath analysis by E-Nose technology as a diagnostic tool for severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pneumonia within a multi-analyst experiment.

Assessment of the incretin effect in healthy subjects: concordance between clamp and OGTT methods.

The incretin effect describes the insulin response to nutrient ingestion that exceeds the response to glycemia per se. It is mediated by gastrointestinal factors and is necessary to maintain postprandial glucose homeostasis. The incretin effect results in a more than twofold increase of the insulin response to a meal in healthy people and two different techniques have been used in the past to measure its magnitude.

Platelet Aggregation Inhibitors and Anticoagulants in Gastroenterological and Visceral Surgical Procedures.

Background: The proper management of patients being treated with platelet aggregation inhibitors or anticoagulant drugs is a common clinical problem for both elective and emergency procedures in gastroenterology and visceral surgery. The essential matters that must be kept in mind in this situation are the hemorrhagic risk of the procedure, the indication for anticoagulation, and the pharmacology of anticoagulant drugs and platelet aggregation inhibitors.

Methods: This review is based on publications retrieved by a selective search in PubMed and on the guidelines of the relevant specialist societies.

Endoscopic Accessibility of the Biliary System in the Postoperative Situs.

Background: Alterations in the anatomy of the upper gastrointestinal tract may pose a challenge to the endoscopist, especially if interventions to the biliary system are indicated in patients with altered continuity of the gastrointestinal tract, impeding to reach the papilla with conventional ERC techniques. The success of any endoscopic intervention in this setting depends on optimal knowledge on the postoperative anatomy in each individual patient.

Summary: If conventional endoscopic retrograde cholangiopancreaticography is impossible, biliary tree access can be achieved by applying novel techniques including endosonography-directed approaches, overtube-assisted approaches or spiral enteroscopy to reach the papilla or biliodigestive anastomosis in case of long limbs, percutaneous or even hybrid approaches.

Discontinuation versus continuation of renin-angiotensin-system inhibitors in COVID-19 (ACEI-COVID): a prospective, parallel group, randomised, controlled, open-label trial.

Background: SARS-CoV-2 entry in human cells depends on angiotensin-converting enzyme 2, which can be upregulated by inhibitors of the renin-angiotensin system (RAS). We aimed to test our hypothesis that discontinuation of chronic treatment with ACE-inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) mitigates the course o\f recent-onset COVID-19.

Methods: ACEI-COVID was a parallel group, randomised, controlled, open-label trial done at 35 centres in Austria and Germany.

Prevalence of the Metabolic Syndrome in Severely Obese Patients Presenting for Bariatric Surgery.

Objective: Although obesity is associated with metabolic changes, not all obese patients are characterized by the metabolic syndrome (MS). The goal of this study was to determine the prevalence of the MS, its characteristics, and the associated demographic factors in a large cohort of severely obese patients presenting for potential bariatric surgery.

Methods: A total of 256 obese patients (68.

Rapid hepatic metabolism blunts the endocrine action of portally infused GLP-1 in male rats.

Glucagon-like peptide-1 (GLP-1) is an enteral peptide that contributes to the incretin effect. GLP-1 action is typically described as endocrine, but this mechanism has been questioned because rapid inactivation in the circulation by dipeptidylpeptidase 4 (DPP4) results in a short half-life, limiting the amount of the hormone that can reach the pancreatic islet. An alternative mechanism for GLP-1 to regulate insulin secretion through neuroendocrine signaling originating from sensors in the portal vein has been proposed.

Predictors of glucose control in children and adolescents with type 1 diabetes: results of a cross-sectional study in Cameroon.

Background: In sub-Saharan Africa the prognosis of children with type 1 diabetes is poor. Many are not diagnosed and those diagnosed have a dramatically reduced life expectancy (less than one year). The purpose of this study was to identify the predictors of glucose control in children and adolescents with type 1 diabetes.

The incretin effect in obese adolescents with and without type 2 diabetes: impaired or intact?

The incretin effect reflects the actions of enteral stimuli to promote prandial insulin secretion. Impairment of this measure has been proposed as an early marker of β-cell dysfunction and described in T2D, IGT, and even obesity without IGT. We sought to determine the effects of obesity and diabetes on the incretin effect in young subjects with short exposures to metabolic abnormalities and a few other confounding medical conditions.

β-Cell Sensitivity to GLP-1 in Healthy Humans Is Variable and Proportional to Insulin Sensitivity.

Context: Glucagon-like peptide-1 (GLP-1) is an insulinotropic factor made in the gastrointestinal tract that is essential for normal glucose tolerance. Infusion of GLP-1 increases insulin secretion in both diabetic and nondiabetic humans. However, the degree to which people vary in their β-cell sensitivity to GLP-1 and the factors contributing to this variability have not been reported.

Meal feeding improves oral glucose tolerance in male rats and causes adaptations in postprandial islet hormone secretion that are independent of plasma incretins or glycemia.

Meal-fed (MF) rats with access to food for only 4 consecutive hours during the light cycle learn to eat large meals to maintain energy balance. MF animals develop behavioral and endocrine changes that permit glucose tolerance despite increased meal size. We hypothesized that enhanced activity of the enteroinsular axis mediates glucose homeostasis during MF.

Severe cytokine release syndrome after the first dose of Brentuximab Vedotin in a patient with relapsed systemic anaplastic large cell lymphoma (sALCL): a case report and review of literature.

Brentuximab Vedotin is an antibody - drug conjugate targeting CD30. We report a case of severe cytokine release syndrome (CRS) after administration of the first dose of Brentuximab Vedotin in a 64-yr-old patient with relapsed systemic anaplastic large cell lymphoma (sALCL). To our knowledge, this is the first case of CRS to Brentuximab Vedotin described in the literature.

Defining the role of GLP-1 in the enteroinsulinar axis in type 2 diabetes using DPP-4 inhibition and GLP-1 receptor blockade.

Understanding the incretin pathway has led to significant advancements in the treatment of type 2 diabetes (T2D). Still, the exact mechanisms are not fully understood. In a randomized, placebo-controlled, four-period, crossover study in 24 patients with T2D, dipeptidyl peptidase-4 (DPP-4) inhibition and its glucose-lowering actions were tested after an oral glucose tolerance test (OGTT).

Suppression of food intake by glucagon-like peptide-1 receptor agonists: relative potencies and role of dipeptidyl peptidase-4.

Administration of the glucagon-like peptide-1 (GLP-1) receptor agonists GLP-1 and exendin-4 (Ex-4) directly into the central nervous system decreases food intake. But although Ex-4 potently suppresses food intake after peripheral administration, the effects of parenteral GLP-1 are variable and not as strong. A plausible explanation for these effects is the rapid inactivation of circulating GLP-1 by dipeptidyl peptidase-4 (DPP-4), an enzyme that does not alter Ex-4 activity.

Exendin-4 increases blood glucose levels acutely in rats by activation of the sympathetic nervous system.

Exendin-4 (Ex-4), an agonist of the glucagon-like peptide-1 receptor (GLP-1R), shares many of the actions of GLP-1 on pancreatic islets, the central nervous system (CNS), and the gastrointestinal tract that mediates glucose homeostasis and food intake. Because Ex-4 has a much longer plasma half-life than GLP-1, it is an effective drug for reducing blood glucose levels in patients with type 2 diabetes mellitus (T2DM). Here, we report that acute administration of Ex-4, in relatively high doses, into either the peripheral circulation or the CNS, paradoxically increased blood glucose levels in rats.

The intestinal lymph fistula model--a novel approach to study ghrelin secretion.

The orexigenic hormone ghrelin is secreted from the stomach and has been implicated in the regulation of energy and glucose homeostasis. We hypothesized that ghrelin, like other gastrointestinal (GI) hormones, is present in intestinal lymph, and sampling this compartment would provide advantages for studying ghrelin secretion in rodents. Blood and lymph were sampled from catheters in the jugular vein and mesenteric lymph duct before and after intraduodenal (ID) administration of isocaloric Ensure, dextrin, or Liposyn meals or an equal volume of saline in conscious Sprague-Dawley rats.

Targeting beta-cell mass in type 2 diabetes: promise and limitations of new drugs based on incretins.

Progressive insulin secretory defects, due to either functional abnormalities of the pancreatic beta-cells or a reduction in beta-cell mass, are the cornerstone of type 2 diabetes. Incretin-based drugs hold the potential to improve glucose tolerance by immediate favorable effect on beta-cell physiology as well as by expanding or at least maintaining beta-cell mass, which may delay the progression of the disease. Long-term studies in humans are needed to elaborate on these effects.

Glucagon-like peptide 1: continued advances, new targets and expanding promise as a model therapeutic.

Purpose Of Review: This article discusses glucagon-like peptide 1 physiology and its various sites of action beyond the incretin effect and highlights recent findings (2005 and 2006).

Recent Findings: Glucagon-like peptide 1 is a physiological incretin in humans and promotes insulin secretion after nutrient ingestion. It is secreted from intestinal L cells after meals and may be partially responsible for the improved glycemic control and weight loss after bariatric surgery.

Combining anthrax vaccine and therapy: a dominant-negative inhibitor of anthrax toxin is also a potent and safe immunogen for vaccines.

Anthrax is caused by the unimpeded growth of Bacillus anthracis in the host and the secretion of toxins. The currently available vaccine is based on protective antigen (PA), a central component of anthrax toxin. Vaccination with PA raises no direct immune response against the bacilli and, being a natural toxin component, PA might be hazardous when used immediately following exposure to B.