Chronic hyperglycemia and intracranial meningiomas

Meningiomas are among the most common primary tumors of the central nervous system. Previous research into the meningioma histological appearance, genetic markers, transcriptome and epigenetic landscape has revealed that benign meningiomas significantly differ in their glucose metabolism compared to aggressive lesions. However, a correlation between the systemic glucose metabolism and the metabolism of the tumor hasn't yet been found. We hypothesized that chronic levels of glycaemia (approximated with glycated hemoglobin (HbA1c)) are different in patients with aggressive and benign meningiomas. The study encompassed 71 patients with de novo intracranial meningiomas, operated on in three European hospitals, two in Croatia and one in Spain. Our results show that patients with WHO grade 2 meningiomas had significantly higher HbA1c values compared to patients with grade 1 lesions (P = 0.0290). We also found a significant number of patients (19/71; 26.7%) being hyperglycemic, harboring all the risks that such a condition entails. Finally, we found a significant correlation between our patients' age and their preoperative HbA1c levels (P = 0.0008, ρ(rho) = 0.388), suggesting that older meningioma patients are at a higher risk of having their glycaemia severely dysregulated. These findings are especially important considering the current routine and wide-spread use of corticosteroids as anti-edematous treatment. Further research in this area could lead to better understanding of meningiomas and have immediate clinical impact.

The Cortical Silent Period in the Cricothyroid Muscle as a Neurophysiologic Feature for Dystonia Observation: E-Field-Navigated Transcranial Magnetic (TMS) Study

The cortical silent period (cSP) is a period of electrical silence following a motor-evoked potential (MEP) in the electromyographic signal recorded from a muscle. The MEP can be elicited by transcranial magnetic stimulation (TMS) over the primary motor cortex site corresponding with the muscle. The cSP reflects the intracortical inhibitory process mediated by GABA_A and GABA_B receptors. The study aimed to investigate the cSP in the cricothyroid (CT) muscle after applying e-field-navigated TMS over the laryngeal motor cortex (LMC) in healthy subjects. Then, a cSP as a neurophysiologic feature for laryngeal dystonia was observed. We applied a single-pulse e-field-navigated TMS to the LMC over both hemispheres with hook-wire electrodes positioned in the CT muscle in nineteen healthy participants, which triggered the elicitation of contralateral and ipsilateral corticobulbar MEPs. The subjects were engaged in a vocalization task, and then we assessed the following metrics: LMC intensity, peak-to-peak MEP amplitude in the CT muscle, and cSP duration. The results showed that the cSP duration from the contralateral CT muscle was distributed from 40 ms to 60.83 ms, and from the ipsilateral CT muscle, from 40 ms to 65.58 ms. Also, no significant difference was found between the contralateral and ipsilateral cSP duration (t(30) = 0.85, p = 0.40), MEP amplitude in the CT muscle (t(30) = 0.91, p = 0.36), and LMC intensity (t(30) = 1.20, p = 0.23). To conclude, the applied research protocol showed the feasibility of recording LMC corticobulbar MEPs and observing the cSP during vocalization in healthy participants. Furthermore, an understanding of neurophysiologic cSP features can be used to study the pathophysiology of neurological disorders that affect laryngeal muscles, such as laryngeal dystonia.

Environmental Risk Factors for Type 1 Diabetes Mellitus Development

Background Although environmental factors induce development of type 1 diabetes mellitus (T1DM) in genetically susceptible individuals, many of those factors have been uncovered. Therefore, the aim of the present study was to analyze associations of T1DM with a wide range of environmental factors. Material and Methods A case-control study was conducted on 249 diabetic and 255 healthy individuals from the Dalmatian region of South Croatia. Data regarding risk factors during pregnancy and early life period of the child were evaluated. Results History of antihypertensive intake (p=0.04) and frequency of stressful life events during pregnancy (p=0.01) were associated with higher risk of T1DM, while hypertension was associated with lower risk of T1DM (p=0.01). Maternal age<25 years at delivery was associated with a higher risk of T1DM (p=0.01).Diabetic patients had a positive family history of T1DM or T2DM (p=0.002) more frequently than controls, while history of infectious diseases was inversely associated with the risk of T1DM (p=0.03). A higher risk of T1DM was significantly associated with earlier introduction of cow's milk (p=0.001), higher number of meals consumed per day (p=0.02), higher frequency of carbohydrate (p=0.001) and meat (p=0.01) consumption and stressful life events during childhood (p=0.02) while earlier introduction of fruit was associated with a lower risk of T1DM (p=0.03) Conclusion This case-control study confirmed associations of a large number of environmental factors with development of T1DM with emphasis on the association of mother's antihypertensive intake during pregnancy, which extends our knowledge about environmental factors related with development of T1DM.

The urinary dehydroepiandrosterone, androsterone and etiocholanolone excretion of healthy women and women with benign and malignant breast disease

The 24-h urinary excretion of dehydroepiandrosterone, androsterone and etiocholanolone was followed in healthy women (n = 50) and in women with benign-fibroadenoma (n = 32), microcysts (n = 32), macrocysts (n = 25) and malignant (n = 35) breast disease aged 35-50 years. The data were analysed in three groups each covering 5 years (35-39, 40-44 and 45-49). A significant decrease in the excretion of etiocholanolone and dehydroepiandrosterone was found in women with benign and malignant breast disease when compared to controls. There was no significant decrease in androsterone excretion in women with benign and malignant breast disease when compared to a control group. A high correlation was found between excretion of etiocholanolone and its precursor dehydroepiandrosterone both in women with benign-fibroadenoma (r = 0.7683) or macrocysts (r = 0.7337) and in women with malignant (r = 0.805) breast disease. Dehydroepiandrosterone and, in particular, etiocholanolone excretions were found to decrease significantly with age in women affected by malignant breast disease.

Influence of interferon on C19-steroids in urine of malignant skin melanoma and malignant breast neoplasm patients

The paper evaluates the effect of human leukocyte interferon (HLI) in patients with malignant skin melanoma and malignant neoplasm of the breast. HLI was administered intramuscularly in a daily dose of 2 X 10(5) IU 7 days at 8-week intervals over a period of 12 months. The chosen patients were in the surgical stage of the disease, i.e. they had undergone surgical operation on the primary tumor or on the regional lymph nodes T1-3, N0-1, M0. During the HLI treatment the values of C19-steroid metabolites and particularly of Dehydroepiandrosterone (DHA) were established and the following conclusions have been drawn: the application of HLI in a dose of 2 X 10(5) by the described method has an impact on the change of C19 steroid metabolism in terms of normalization.