Poor risk factor control in outpatients with diabetes mellitus type 2 in Germany: The DIAbetes COhoRtE (DIACORE) study.

INTRODUCTION: Patients with diabetes mellitus type 2 (DM2) are at high risk for micro- and macrovascular disease. Here, we explore the degree of traditional risk factor control in the baseline visit of a cohort of DM2 outpatients. METHODS: DIACORE (DIAbetes COhoRtE) is a prospective cohort study of 3000 adult DM2 outpatients. Here, we present results from the baseline visit. Sociodemographic and anthropometric variables, cardiovascular risk factors, comorbidities and medication were assessed by interview and medical exams. Serum-creatinine based estimated glomerular filtration rate (eGFRcrea) and urinary albumin-creatinine ratio (UACR) were determined for classification of chronic kidney disease (CKD). The proportion of patients with adequate control of traditional risk factors (blood pressure<140/90mmHg, HbA1c<7.5%, LDL<100mg/dl) was calculated in 2892 patients with non-missing data in 9 relevant variables within each KDIGO 2012 CKD class. RESULTS: In the analyzed baseline data (n = 2892, 60.2% men), mean (standard deviation) values for age, DM2 duration and HbA1c were 65.3 (9.3) years, 10.3 (8.4) years and 6.9% (1.1) respectively. Of these 2892 patients, 18.7% had CKD stage 3 or higher, 25.7% had UACR≥30mg/g. Adequate blood pressure, HbA1c and LDL control was achieved in 55.7%, 78.5% and 34.4%, respectively. In 16.4% of patients (473), all three risk factors were below recommended targets. The proportion of adequate risk factor control was similar across KDIGO eGFRcrea classes. Adequate blood pressure and HbA1c control were significantly associated with lower UACR category without and with controlling for other risk factors (p<0.0001, p = 0.0002, respectively). CONCLUSION: In our study of patients with diabetes mellitus type 2, we observed a low level of risk factor control indicating potential for risk reduction.

Chicken intestine microbiota following the administration of lupulone, a hop-based antimicrobial.

The use of antibiotic growth promotants in poultry rearing is a public health concern due to antibiotic resistance in bacteria and the harborage of resistance genes. Lupulone, a hop ß-acid from Humulus lupulus, has been considered as a potential feed additive growth promotant. Here, the effect of lupulone was evaluated for its effect on the microbiota of the chicken intestine. The intestinal microbiota of broilers was quantified after the addition of 125 mg L(-1) lupulone to water and challenge with Clostridium perfringens. Microbial DNA was extracted from the broiler midgut and cecal sections and bacterial groups were quantified using real-time PCR. The predominant cecal bacterial groups were Clostridium leptum subgroup 16S rRNA gene Cluster IV, Clostridium coccoides subgroup 16S rRNA gene Clusters XIVa and XIVb and Bacteroides, whereas Lactobacillus, the Enterobacteriaceae family and Enterococcus dominated the midgut. Lupulone at 125 mg L(-1) significantly decreased the C. perfringens subgroup 16S rRNA gene Cluster I, which contains several pathogenic species, in both the midgut and the cecum and Lactobacillus in the midgut. No significant changes were noted in the overall microbiota for the cecum or the midgut. Lupulone warrants further evaluation as a botanical agent to mitigate C. perfringens overgrowth in antibiotic-free reared poultry.

Direct inhibition of elastase and matrixmetalloproteinases and stimulation of biosynthesis of fibrillar collagens, elastin, and fibrillins by xanthohumol.

In skin aging there is deterioration of the extracellular matrix's collagen and elastin fibers, from its reduced biosynthesis and increased degradation by elastase and matrixmetalloproteinases (MMPs). Xanthohumol is a flavonoid isolated from the hop plant Humulus lupulus L., with anti-microbial, antioxidant, anti-inflammatory, and anti-carcinogenic properties. The goal of this research was to investigate xanthohumol as an anti-skinaging agent via its beneficial regulation of the extracellular matrix. To this purpose, we examined the direct effect of xanthohumol on the activities of elastase and MMPs (MMPs 1, 2, and 9) and its effect on the expression (protein and/or transcription levels) of collagens (types I, III, and V), elastin, and fibrillins (1 and 2) in dermal fibroblasts. Xanthohumol significantly inhibited elastase and MMP-9 activities from its lowest concentration, and MMP-1 and MMP-2 at its higher concentrations, which implies a greater protective effect on elastin. It dramatically increased the expression of types I, III, and V collagens, and elastin, fibrillin-1, and fibrillin-2 in dermal fibroblasts. The effects were similar to those of ascorbic acid. This is the first report identifying xanthohumol's potential to improve skin structure and firmness: it simultaneously inhibits the activities of elastase/MMPs and stimulates the biosynthesis of fibrillar collagens, elastin, and fibrillins.

Charcot-Marie-Tooth neuropathy type 2A: novel mutations in the mitofusin 2 gene (MFN2).

BACKGROUND: Charcot-Marie-Tooth neuropathies are a group of genetically heterogeneous diseases of the peripheral nervous system. Mutations in the MFN2 gene have been reported as the primary cause of Charcot-Marie-Tooth disease type 2A. METHODS: Patients with the clinical diagnosis of Charcot-Marie-Tooth type 2 were screened using single strand conformation polymorphism (SSCP). All DNA samples showing band shifts in the SSCP analysis were amplified from genomic DNA and cycle sequenced. RESULTS: We analyzed a total of 73 unrelated patients with a clinical diagnosis of CMT 2. Overall, novel mutations were detected in 6 patients. c.380G>T (G127V), c.1128G>A (M376I), c.1040A>T (E347V), c.1403G>A (R468H), c.2113G>A (V705I), and c.2258_2259insT (L753fs). CONCLUSION: We confirmed a significant role of mutations in MFN2 in the pathogenesis of Charcot-Marie-Tooth disease type 2.

On the formation of aliphatic polycarbonates from epoxides with chromium(III) and aluminum(III) metal-salen complexes.

A DFT-based description is given of the CO2/epoxide copolymerization with a catalyst system consisting of metal (chromium, iron, titanium, aluminum)-salen complexes (salen = N,N'-bis(3,5-di-tert-butylsalicyliden-1,6-diaminophenyl) in combination with either chloride, acetate, or dimethylamino pyridine (DMAP) as external nucleophile. Calculations indicate that initiation proceeds through nucleophilic attack at a metal-coordinated epoxide, and the most likely propagation reaction is a bimolecular process in which a metal-bound nucleophile attacks a metal-bound epoxide. Carbon dioxide insertion occurs at a single metal center and is most likely the rate-determining step at low pressure. The prevalent chain terminating/degradation-the so-called backbiting, a reaction leading to formation of cyclic carbonate from the polymer chain-would involve attack of a carbonate nucleophile rather than an alkoxide at the last unit of the growing chain. The backbiting of a free carbonato chain end is particularly efficient. Anion dissociation from six-coordinate aluminum is appreciably easier than from chromium-salen complexes, indicating the reason why in the former case cyclic carbonate is the sole product. Experimental data were gathered for a series of chromium-, aluminum-, iron-, and zinc-salen complexes, which were used in combination with external nucleophiles like DMAP and mainly (tetraalkyl ammonium) chloride/acetate. Aluminum complexes transform PO (propylene oxide) and CO2 to give exclusively propylene carbonate. This is explained by rapid carbonate anion dissociation from a six-coordinate complex and cyclic formation. CO2 insertion or nucleophilic attack of an external nucleophile at a coordinated epoxide (at higher CO2 pressure) are the rate-determining steps. Catalysis with [Cr(salen)(acetate/chloride)] complexes leads to the formation of both cyclic carbonate and polypropylene carbonate with various quantities of ether linkages. The dependence of the activity and selectivity on the CO2 pressure, added nucleophile, reaction temperature, and catalyst concentration is complex. A mechanistic description for the chromium-salen catalysis is proposed comprising a multistep and multicenter reaction cycle. PO and CO2 were also treated with mixtures of aluminum- and chromium-salen complexes to yield unexpected ratios of polypropylene carbonate and cyclic propylene carbonate.

Antimicrobial Activity of Hop Resins.

The antimicrobial activity of hop resins against Streptococcus salivarius , Staphylococcus aureus (two strains), Bacillus megaterium , Escherichia coli B, and Bacillus subtilis was investigated. However, resistance development was carried out on Streptococcus salivarius , Staphylococcus aureus (two strains), and Bacillus megaterium . The two hop resins used were iso-alpha resin and beta resin. Prior to resistance development, S. salivarius , S. aureus , and B. megaterium were all inhibited by the iso-alpha-hop resin in the 0.01 to 0.03% range. The beta-hop resin which, according to the literature, is more active than the iso-alpha resin initially inhibited these organisms at the 0.003 to 0.01% concentrations. The ease of resistance development varied between the different microbes, B. megaterium being the least prone to develop resistance.

Antimicrobial Activity of Some Edible Plants: Lotus ( Nelumbo nucifera ), Coffee, and Others.

A number of edible plant species were investigated for antifungal agents. Whole sprouts and extracts of plant organs were tested in several assays, including bioautography. Amaranth, coffee ( Coffea arabica ), rice, coleus, violet, chervil, and lotus ( Nelumbo nucifera ) showed antifungal activity. Rhizomes of lotus had potent antifungal activity against Aspergillus niger , Trichoderma viride , and Penicillium spp. Further work is merited for characterization of this antifungal agent. Screening of sprouting plants and terrestrial aquatic plants may be a fruitful approach to finding new antimicrobials.