Programme Hospitalier Recherche Clinique, Institut Pasteur, Inserm, French Public Health Agency.

Glyburide's PK and PD have not been studied in women with gestational diabetes mellitus (GDM). The objective was to assess steady-state PK of glyburide as well as insulin sensitivity, beta-cell responsivity and overall disposition indices following a mixed meal tolerance test (MMTT) in GDM (n=40), non-pregnant type 2 diabetic (T2DM) (n=26) and healthy pregnant (n=40, MMTT only) women. At equivalent doses, glyburide plasma concentrations were ~50% lower in pregnancy compared to non-pregnant women. Average glyburide umbilical cord to maternal plasma concentration ratio at the time of delivery was 0.7 ± 0.4. Insulin sensitivity was ~5-fold lower in women with GDM compared to healthy pregnancy. Despite comparable beta-cell responsivity index, average beta-cell function corrected for insulin resistance was >3.5-fold lower in women with glyburide-treated GDM than healthy pregnancy. Women with GDM that fail glyburide may benefit from alternate medication selection or dosage escalation, though fetal safety should be considered.Corresponding Author and Reprint Requests: Mary F. Hebert, Pharm.D., FCCP, University of Washington, Department of Pharmacy, 1959 NE Pacific St., H-375 Health Science Center, Box 357630, Seattle WA 98195-7630, Phone: 206-616-5016, Fax: 206-543-3835, Email: E-mail: mhebert@u.washington.edu. * Current address: Pfizer Global Research and Development, San Diego CA CONFLICT OF INTEREST/DISCLOSURE At the time of study conduct and analysis, the authors declare no conflict of interest. However, since completion of the study, Dr. Vicini's affiliation has become Pfizer Global Research and Development. NIH Public Access Author ManuscriptClin Pharmacol Ther. Author manuscript; available in PMC 2010 June 1. Published in final edited form as:Clin Pharmacol Ther. Gestational diabetes mellitus (GDM) complicates 5-12% of pregnancies and is associated with adverse pregnancy outcomes. Insulin has been the mainstay of pharmacotherapy for GDM. Glyburide's (GLY) advantages include easier route of administration and schedule as well as improved patient satisfaction and adherence. GLY's acceptance has been due to its comparable efficacy with insulin and limited transfer to the fetus.(1,2) However, the pharmacokinetics (PK) of GLY have not been studied in pregnancy and dosage strategies generally follow those used in non-pregnant patients with type 2 diabetes mellitus (T2DM). We hypothesized that the PK of GLY would be different during pregnancy, due to the expected changes in metabolism, protein binding, and body composition. In addition, the effects of GLY on the insulin sensitivity and secretion parameters have not been systematically studied. Our objectives were to compare GLY PK in women with GDM and non-pregnant T2DM, to measure fetal exposure to glyburide at delivery and to evaluate insulin sensitivity (SI), beta-cell responsivity index (Φ total ) and disposition index (DI) following a mixed meal tolerance test (MMTT) in women with GDM on GLY therapy, compared with gestational age-matched healthy pregnant ...

Surgical treatment is a safe and effective treatment for acromegaly and remains the first choice of treatment for most acromegalic patients. The results of this centre compare favourably with series from other centres. We have demonstrated improved results, both in terms of post operative growth hormone values and pituitary function tests with time and increasing neurosurgical experience. We conclude that outcome for the surgical treatment for acromegaly is best achieved with one surgeon specialising in pituitary surgery. Improved operative outcome thus achieved has major cost implications and avoids the necessity for consideration of postoperative radiotherapy and the use of expensive growth hormone suppressing drugs in the postoperative period.

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low-or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI).Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression.

Recent reports have linked severe lung injuries and deaths to the use of e-cigarettes and vaping products. Nevertheless, the causal relationship between exposure to vaping emissions and the observed health outcomes remains to be elucidated. Through chemical and toxicological characterization of vaping emission products, this study demonstrates that during vaping processes, changes in chemical composition of several commonly used vape juice diluents (also known as cutting agents) lead to the formation of toxic byproducts, including quinones, carbonyls, esters, and alkyl alcohols. The resulting vaping emission condensates cause inhibited cell proliferation and enhanced cytotoxicity in human airway epithelial cells. Notably, substantial formation of the duroquinone and durohydroquinone redox couple was observed in the vaping emissions from vitamin E acetate, which may be linked to acute oxidative stress and lung injuries reported by previous studies. These findings provide an improved molecular understanding and highlight the significant role of toxic byproducts in vapingassociated health effects.

Oxidative potential (OP) has been proposed as a useful descriptor for the ability of particulate matter (PM) to generate reactive oxygen species (ROS) and consequently induce oxidative stress in biological systems, which has been recognized as one of the most important mechanisms responsible for PM toxicity. The dithiothreitol (DTT) assay is one of the most frequently used techniques to quantify OP because it is low-cost, easy-to-operate, and has high repeatability. With two thiol groups, DTT has been used as a surrogate of biological sulfurs that can be oxidized when exposed to ROS. Within the DTT measurement matrix, OP is defined as the DTT consumption rate. Often, the DTT consumption can be attributed to the presence of transition metals and quinones in PM as they can catalyze the oxidation of DTT through catalytic redox reactions. However, the DTT consumption by non-catalytic PM components has not been fully investigated. In addition, weak correlations between DTT consumption, ROS generation, and cellular responses have been observed in several studies, which also reveal the knowledge gaps between DTT-based OP measurements and their implication on health effects. In this review, we critically assessed the current challenges and limitations of DTT measurement, highlighted the understudied DTT consumption mechanisms, elaborated the necessity to understand both PM-bound and PM-induced ROS, and concluded with research needs to bridge the existing knowledge gaps.

Dimethyl selenide (DMSe) is one of the major volatile organoselenium compounds released from aquatic and terrestrial environments through microbial transformation and plant metabolism. The detailed processes of DMSe leading to secondary organic aerosol (SOA) formation and the pulmonary health effects induced by inhalation of DMSe-derived SOA remain largely unknown. In this study, we characterized the chemical composition and formation yields of SOA produced from the oxidation of DMSe with OH radicals and O3 in controlled chamber experiments. Further, we profiled the transcriptome-wide gene expression changes in human airway epithelial cells (BEAS-2B) after exposure to DMSe-derived SOA. Our analyses indicated a significantly higher SOA yield resulting from the OH-initiated oxidation of DMSe. The oxidative potential of DMSe-derived SOA, as measured by the dithiothreitol (DTT) assay, suggested the presence of oxidizing moieties in DMSe-derived SOA at levels higher than typical ambient aerosols. Utilizing RNA sequencing (RNA-Seq) techniques, gene expression profiling followed by pathway enrichment analysis revealed several major biological pathways perturbed by DMSe-derived SOA, including elevated genotoxicity, DNA damage, and p53-mediated stress responses, as well as downregulated cholesterol biosynthesis, glycolysis, and interleukin IL-4/IL-13 signaling. This study highlights the significance of DMSe-derived SOA as a stressor in human airway epithelial cells.

Objective  To determine the cellular expression of Fas, Fas ligand and interleukin‐1β converting enzyme (ICE) in prostatic cancer. Patients and methods  Specimens of prostate were obtained from 21 patients (mean age 66 years, sd 5) undergoing radical prostatectomy for prostatic cancer. Nine of the 21 patients had received endocrine therapy before surgery. Specimens were also obtained from 10 patients with benign prostatic hypertrophy (BPH) and during autopsy from 10 patients who had died from hormone‐unresponsive prostate cancer. Paraffin‐embedded sections were cut from the specimens and stained immunohistochemically to detect Fas, Fas ligand and ICE. Results  Fas was expressed in all 21 of the cancer specimens while Fas ligand was detected in none and ICE was expressed in 11. The difference between the expression of Fas and ICE was significant (P<0.001). ICE was expressed in nine of 12 patients who were untreated before surgery and in two of nine treated with endocrine therapy (P<0.05). Fas expression was detected in the specimens from all 10 patients with BPH and in all 10 autopsy specimens; the expression tended to be more marked than that in specimens from total prostatectomy (P<0.1). Conclusion  The expression of ICE was weaker than that of Fas in the total prostatectomy specimens, suggesting a possible interruption of the apoptotic signalling pathway. Prostates with BPH and hormone‐unresponsive cancer therefore showed no appreciable change in Fas expression when compared with total prostatectomy samples.